Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation

Diabetic MedicineVolume 15, Issue 7 p. 539-553 Special Report Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation K.G.M.M. Alberti, Corresponding Author K.G.M.M. Alberti Department of Medicine, University of Newcastle upon Tyne, UKDepartment of Medicine, The Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UKSearch for more papers by this authorP.Z. Zimmet, P.Z. Zimmet International Diabetes Institute, Caulfield, AustraliaSearch for more papers by this author K.G.M.M. Alberti, Corresponding Author K.G.M.M. Alberti Department of Medicine, University of Newcastle upon Tyne, UKDepartment of Medicine, The Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UKSearch for more papers by this authorP.Z. Zimmet, P.Z. Zimmet International Diabetes Institute, Caulfield, AustraliaSearch for more papers by this author First published: 19 July 2004 https://doi.org/10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-SCitations: 951AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to ≥7.0 mmol l−1 (6.1 mmol l−1). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma ≥6.1 to <7.0 mmol l−1; whole blood ≥5.6 to <6.1 mmol l−1). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements. © 1998 WHO Citing Literature Volume15, Issue7July 1998Pages 539-553 RelatedInformation