Skip to main content

Limitations and Problems of Diabetes Classification from an Epidemiological Point of View

  • Chapter
Comparison of Type I and Type II Diabetes

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 189))

Abstract

Classifications of disease are man-made devices to assist in the ordering of thought or the organization of action. It follows that they depend upon the current state of knowledge and that as knowledge increases so classification may change. It also follows that the nature of the classification will depend upon the type of action to be organized. Thus a classification appropriate to a clinician whose concern is with diagnosis and treatment may well be inappropriate to a basic scientist whose concern is research strategy and experimental design. The public health agent will require a classification which assists in provision of health care resources and the planning of preventive approaches. Epidemiological needs will also make special demands of a classification, the main requirement being for clear, unambiguous definitions. The classification formulated by the US National Diabetes Data Group (NDDG)1 and adopted in the Second Report of the World Health Organization Expert Committee on Diabetes Mellitus (WHO)2 (see abbreviated version, Table 1) goes a long way to meet the varying needs of these different user groups but falls short of perfection as is inevitable in any attempt to meet them all. It is the residual problems, mainly those for the epidemiologist, that are dealt with here.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. National Diabetes Data Group, Classification and diagnosis of diabetes and other categories of glucose intolerance, Diabetes 28: 139–157 (1979).

    Google Scholar 

  2. World Health Organisation Expert Committee, Second Report on Diabetes Mellitus, Tech. Rep. Series 646, WHO, Geneva (1980).

    Google Scholar 

  3. H. Keen, S. Tang Ng Fui, The definition and classification of diabetes mellitus, Clin. Endocrinol Metab. 11: 279–305 (1982).

    Article  CAS  Google Scholar 

  4. K.M. West, Substantial differences in diagnostic criteria used by diabetes experts, Diabetes 24: 641–664 (1975).

    Article  PubMed  CAS  Google Scholar 

  5. H. Keen, R.J. Jarrett, P. McCartney, The ten-year follow-up of the Bedford Survey (1962–1972): glucose tolerance and diabetes, Diabetologia 22: 73–78 (1982).

    Article  PubMed  CAS  Google Scholar 

  6. T. Kadowaki, Y. Miyake, R. Hagura et al., Risk factors for worsening to diabetes in subjects with impaired glucose tolerance, Diabetologia 26: 44–49 (1984).

    Article  PubMed  CAS  Google Scholar 

  7. J.B. O’Sullivan, C.M. Mahan, Blood sugar levels, glycosuria and body weight related to development of diabetes mellitus, J. Am Med. Assoc. 194: 117–122 (1965).

    Article  Google Scholar 

  8. R.J. Jarrett, H. Keen, J.H. Fuller, M. McCartney, Worsening to diabetes in men with impaired glucose tolerance (’borderline diabetes’), Diabetologia 16: 25–30 (1979).

    Article  PubMed  CAS  Google Scholar 

  9. A. Sasaki, T. Suzuki, N. Horiuchi, Development of diabetes in Japanese subjects with impaired glucose tolerance; a seven year follow-up study, Diabetologia 22: 154–157 (1982).

    Article  PubMed  CAS  Google Scholar 

  10. J.H. Fuller, M.J. Shipley, G. Rose, R.J. Jarrett, H. Keen, Coronary heart disease risk and impaired glucose tolerance: The Whitehall Study, Lancet 1: 1373–1376 (1980).

    Article  PubMed  CAS  Google Scholar 

  11. R.J. Jarrett, P. McCartney, H. Keen, The Bedford Survey: Ten year mortality rates in newly diagnosed diabetics, borderline diabetes and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics, Diabetologia 22: 79–84 (1982).

    PubMed  CAS  Google Scholar 

  12. J.H. Fuller, M.J. Shipley, G. Rose, R.J. Jarrett, H. Keen, Mortality from coronary heart diease and stroke in relation to degree of glycaemia: The Whitehall Study, Br. Med. J. 287: 867870 (1983).

    Google Scholar 

  13. R. Stamler, and J. Stamler, Asymptomatic hyperglycaemia and coronary heart disease: a series of papers by the international collaborative group based on studies in fifteen populations, J. Chron Dis. 32: 683–837 (1979).

    Article  Google Scholar 

  14. P.J. Savage, P.H. Bennett, P. Gorden, M. Miller, Insulin response to oral carbohydrate in true prediabetics and matched controls, Lancet 1: 300–302 (1975).

    Article  PubMed  CAS  Google Scholar 

  15. R.J. Jarrett, Reflections on gestational diabetes mellitus, Lancet 2: 1220–1222 (1981).

    Article  PubMed  CAS  Google Scholar 

  16. H. Keen, Glucose intolerance in pregnancy. Diabetologia 24: 460–461 (1983).

    Article  PubMed  CAS  Google Scholar 

  17. M.I. Harris, W.C. Hadden, W.C. Knowler, P.H. Bennett, “International criteria for the diagnosis of diabetes and impaired glucose tolerance” (In Press) (1984).

    Google Scholar 

  18. L. Jovanovic, C. Peterson, The clinical utility of glycosylated hemoglobin, Am. J. Med. 70: 331–338 (1981).

    Article  PubMed  CAS  Google Scholar 

  19. P.M. Hall, J.G.H. Cook, J. Sheldon, S.M. Rutherford, B.J. Gould, Glycosylated hemoglobins and glycosylated plasma proteins in the diagnosis of diabetes mellitus and impaired glucose tolerance, Diabetes Care 7: 147–150 (1984).

    Article  PubMed  CAS  Google Scholar 

  20. M. Modan, H. Halkin, A. Karasik, A. Lusky, Effectiveness of glycosylated haemoglobin, fasting plasma glucose and a single post-load plasma glucose level in population screening for glucose intolerance, Amer. J. Epidemiol 119: 431–444 (1984).

    CAS  Google Scholar 

  21. U. Di Mario, W.J. Irvine, D.Q. Borsey et al., Immune abnormalities in diabetic patients not requiring insulin at diagnosis, Diabetologia 25: 392–395 (1983).

    Article  PubMed  Google Scholar 

  22. S. Ng Tang Fui, H. Keen, R.J. Jarrett et al., Epidemiological study of prevalence of chlorpropamide alcohol flushing in insulin dependent diabetics, non-insulin dependent diabetics and non-diabetics, Br. Med. J. 287: 1509–1512 (1983).

    Article  Google Scholar 

  23. R.B. Tattersall, R.H. Wilson, P. van der Minne, I. Deverill, K. Gelsthorpe, W.G. Reeves, Problems with the classification of Type I diabetes - a prospective study, Diabetic Med. (In Press) (1984).

    Google Scholar 

  24. S. Ng Tang Fui, H. Keen, R.J. Jarrett, W. Gossanin, P. Marsden, Test for chlorpropamide treatment in insulin-dependent and noninsulin-dependent diabetics, N. Eng. J. Med. 3009: 93–96 (1983).

    Google Scholar 

  25. P.S. Rotwein, J. Chirgwin, M. Province et al., Polymorphism in the 5’ flanking region of the human insulin gene: a genetic marker for non-insulin-dependent diabetes, N. Eng. J. Med. 308: 65–71 (1983).

    Article  CAS  Google Scholar 

  26. H. Keen, J.K. Ekoe, The geography of diabetes, Brit Med. Bull 40: 359: 365 (1984).

    Google Scholar 

  27. E. Morrison, Diabetes mellitus–a third syndrome, Phasic insulin dependence (PID), Int. Diab. Fed. Bull 26: 6–8 (1981).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1985 Springer Science+Business Media New York

About this chapter

Cite this chapter

Keen, H. (1985). Limitations and Problems of Diabetes Classification from an Epidemiological Point of View. In: Vranic, M., Hollenberg, C.H., Steiner, G. (eds) Comparison of Type I and Type II Diabetes. Advances in Experimental Medicine and Biology, vol 189. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1850-8_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-1850-8_3

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-1852-2

  • Online ISBN: 978-1-4757-1850-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics