Basis of the Present Classification of Diabetes

  • Peter H. Bennett
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 189)


The present classification of diabetes most widely used is that recommended by the National Diabetes Data Group and subsequently endorsed by the World Health Organization. This classification is primarily a clinical classification of diabetes because in most instances the etiology is unknown. The need for a standardized classification arose out of the recognition that diabetes was a syndrome rather than a single disease and the different terminologies which emerged. While certain types of diabetes can be classified according to specific etiology or associations with specific syndromes, the vast majority cannot. Insulin-dependent and noninsulin-dependent diabetes usually represent syndromes whose etiopathology is believed to differ and their clinical characteristics are usually distinctive. As evidence of etiological heterogeneity has increased there has been a tendency to adopt the terms Type I and Type II diabetes to indicate different etiologies, although the original usage of these terms was as a clinical classification to differentiate between insulin dependent and non-insulindependent disease. At present the use of the four terms to describe the common types of diabetes leads to confusion, which could readily be resolved by arriving at agreed definitions for each of these terms. While the NDDG-WHO classification has served to standardize terminology and stimulate research into the different causes of diabetes, some further refinement of the classification, together with some additional definition of terms, should be considered.

The classification of diabetes most widely used at the present time is that suggested by the National Diabetes Data Group (NDDG) in the United States in 1979,15 which was subsequently recommended by the World Health Organization (WHO) Expert Committee on Diabetes Mellitus in 1980.20 It should be stressed that this classification was intended to be a uniform framework for clinical and epidemiological research, and that the classification would almost certainly have to be modified on the basis of new knowledge in the future.


Glucose Tolerance Impaired Glucose Tolerance Gestational Diabetes Glycogen Storage Disease Islet Cell Antibody 
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  1. 1.
    J.P. Bantle, D.C. Laine, B.J. Hoogwerf, and F.0 Goetz, The potential usefulnes of postprandial urine C-peptide measurement in classifying diabetic patients, Diabetes Care 7: 202–203 (1984).PubMedGoogle Scholar
  2. 2.
    P.H. Bennett, W.C. Knowler, D.J. Pettitt, and H.R. Baird, Differences in the National Diabetes Data Group (NDDG) and World Health Organization (WHO) criteria for diabetes (DM) and impaired glucose tolerance (IGT), Diabetes 32 (Suppl. 1): 110A (1983).Google Scholar
  3. 3.
    A. Bouchardat, De la glycosurie au diabète sucré: Son Traitment Hygiénique, Paris: Germer-Balliere,: 180 (1875).Google Scholar
  4. 4.
    A.G. Cudworth, The aetiology of diabetes mellitus, Br. J. Hosp. Med. 16: 207–216 (1976).Google Scholar
  5. 5.
    A.G. Cudworth, Type 1 diabetes mellitus, Diabetologia 14: 281–291 (1978).PubMedCrossRefGoogle Scholar
  6. 6.
    G.F. Bottazzo, and D. Doniach, Pancreatic autoimmunity and HLA antigens, Lancet 2: 800 (1976).PubMedCrossRefGoogle Scholar
  7. 7.
    A.N. Gorsuch, K.M. Spencer, J. Lister, J.M. McNally, B.M. Dean, G.F. Bottazzo, and A.G. Cudworth, Evidence for a long prediabetic period in type 1 (insulin dependent) diabetes mellitus, Lancet 2: 1363–1365 (1981).PubMedCrossRefGoogle Scholar
  8. 8.
    A.N. Gorsuch, K.H. Spencer, J. Lister, E. Wolf, G.F. Bottazzo, and A.G. Cudworth, Can future Type 1 diabetes be predicted? A study of families of affected children, Diabetes 31: 862–866 (1982).PubMedCrossRefGoogle Scholar
  9. 9.
    H. Harris, The familial distribution of diabetes mellitus: A study of the relatives of 1241 diabetic propositi, Ann. Eugen. 15: 95–119 (1950).Google Scholar
  10. 10.
    H.P. Himsworth, Diabetes mellitus: Its differentiation into insulin-sensitive and insulin-insensitive types, Lancet 1: 117–120 (1936).Google Scholar
  11. 11.
    H.P. Himsworth, The syndrome of diabetes mellitus and its causes, Lancet 1: 465–473 (1949).PubMedCrossRefGoogle Scholar
  12. 12.
    P. Hugh-Jones, Diabetes in Jamaica, Lancet 2: 891–897 (1955).CrossRefGoogle Scholar
  13. 13.
    N.J. Irvine, Classification of idiopathic diabetes, Lancet 1: 638–642 (1977).PubMedCrossRefGoogle Scholar
  14. 14.
    R.D. Lawrence, Types of human diabetes, Br. Med. J. 1: 373–375 (1951).PubMedCrossRefGoogle Scholar
  15. 15.
    National Diabetes Data Group, Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance, Diabetes 28: 1039–1057 (1979).Google Scholar
  16. 16.
    J.Nerup, M. Christy, A. Green, M. Hauge, P. Platz, L.P. Ryder, A. Svejgaard, and M. Thompsen, HLA and insulin dependent diabetes–population studies, in: “The Genetics of Diabetes Mellitus,” J. Kobberling and R. Tattersall, eds., Academic Press, London and New York, (1981), p. 33–42.Google Scholar
  17. 17.
    A.L. Rosenbloom, S.S. Hunt, E.K. Rosenbloom, and N. Madaren, Ten-year prognosis of impaired glucose tolerance in siblings of patients with insulin-dependent diabetes, Diabetes 31: 385–387 (1982).PubMedCrossRefGoogle Scholar
  18. 18.
    C.R. Stiller, J. Dupre, M. Gent, M.R. Jenner, P.A. Keown, A. Laupacis, R. Martell, N.W. Rodger, B.V. Graffenried, and B.M.J. Wolfe, Effects of cyclosporine immunosuppression insulin-dependent diabetes mellitus of recent onset, Science 223: 1362–1367 (1984).PubMedCrossRefGoogle Scholar
  19. 19.
    T.A. Welborn, P. Garcia-Webb, and A.M. Bousen, Basal C-peptide in the discrimination of type 1 from type 11 diabetes, Diabetes Care 4: 616–619 (1981).CrossRefGoogle Scholar
  20. 20.
    WHO Expert Committee on Diabetes Mellitus, in: “Second Report,” World Health Organization Technical Report Series 646. Geneva: World Health Organization (1980).Google Scholar

Copyright information

© Springer Science+Business Media New York 1985

Authors and Affiliations

  • Peter H. Bennett
    • 1
  1. 1.Epidemiology and Field Studies BranchNIADOK, NIHPhoenixUSA

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