Diagnostic criteria for acute-onset type 1 diabetes mellitus (2012)

Abstract

Type 1 diabetes is a disease characterized by destruction of pancreatic β cells, which leads to absolute deficiency of insulin secretion. Depending on the manner of onset and progression, it is classified as fulminant, acute-onset, or slowly progressive type 1 diabetes. Here, we propose the diagnostic criteria for acute-onset type 1 diabetes mellitus. Among the patients who developed diabetic ketosis or ketoacidosis within 3 months after the onset of hyperglycemic symptoms and need insulin treatment continuously after the diagnosis of diabetes, patients with anti-islet autoantibodies are diagnosed with “acute-onset type 1 diabetes mellitus (autoimmune)”. On the other hand, those whose endogenous insulin secretion is exhausted [fasting serum C peptide immunoreactivity (CPR) < 0.6 ng/ml] without verifiable anti-islet autoantibodies are diagnosed simply with “acute-onset type 1 diabetes mellitus”. Patients should be reevaluated after certain periods in case their statuses of anti-islet autoantibodies and/or endogenous insulin secretory capacity is unknown.