Diabetes diagnosis and classification

With the recent years diabetic epidemiology, etiology, pathogenesis and clinical research in-depth and continuous progress in 1996, December 9-13 held in the United Kingdom WHO criteria for diagnosis of diabetes and its complications and sub-advisory member of the Meeting to consider carefully the 1979 NDDG [1], 1980 and 1985, WHO made the diagnosis and classification of the reasonableness of the law, combined with in the past 17 years, the study found that diabetes diagnosis and typing out a preliminary proposal. The new classification based on the cause of diabetes, rather than according to their clinical performance, more scientific and reasonable. Be divided into four types as follows: Type 1 diabetes [3, 7, 8] islet β cells led to the destruction of an absolute lack of insulin. Into autoimmune (including the acute onset and slow onset) and idiopathic (idiopathic type 1 diabetes, a minority, the cause is unknown, the lack of pancreatic islet β cells in the body's own immune evidence of a strong genetic tendency). Further sure, "LADA diabetes (latent autoimmune diabetes in adults, LADA)" should belong to the subtype of type 1 diabetes, characterized as: ① age of onset is greater than any of the 15-year-old age group, the incidence of six months is not Insulin-dependent, non-ketosis occurred; ② when the incidence of non-obese; ③ islet β cells in the body antibodies (ICA, GAD and insulin autoantibodies, etc.) often continued positive; ④ with type 1 diabetes susceptibility gene (for example, HLA-DR3 , HLA-DR4, BW54 and DQ-131-57-Non-Asp, etc.); ⑤ are often accompanied by thyroid and stomach wall cells, such as organ-specific antibody-positive. LADA one should be diagnosed early adoption of insulin treatment in order to protect the remnants of β cells. LADA Europe and the United States who report information about type 2 diabetes by 10% -15% in non-obese patients with type 2 diabetes have reported that up to 50%; cents States have reported type -2 diabetes GAD-Ab positive rate of 14.2% Type 2 diabetes [3,9,10] insulin resistance mainly with lack of insulin secretion, or lack of insulin secretion mainly with or without insulin resistance. All patients with diabetes account for about 90%, its cause is unknown, it is considered by many genetic and environmental factors (mainly for the lack of movement and the relative surplus of energy) common trigger, race, family history, obesity (especially abdominal obesity) , Hyperlipidemia, and impaired glucose tolerance is a risk factor for these groups should step up monitoring of blood glucose. It includes a series of specific causes of diabetes compared with the explicit or secondary diabetes, mainly in the following categories [3]: 1. Islet abnormal gene β-cell function: mainly young adult onset diabetes mellitus (MODY) and mitochondrial diabetes. ① MODY: According to the abnormal gene in three different subtypes [3,5,11]: chromosome 12, HNF12 (MODY3); chromosome 7, glucokinase (MODY2); chromosome 20, HNF-4α (MODY1). MODY characteristics: onset diabetes often <25>