Report of the Committee of the Japan Diabetes Society on the Research of Fulminant and Acute-onset Type 1 Diabetes Mellitus: New Diagnostic Criteria for Fulminant Type 1 Diabetes Mellitus (2012)

Abstract

We have revised a part of the diagnostic criteria for fulminant type 1 diabetes as "Criteria for definite diagnosis of fulminant type 1 diabetes mellitus (2012)". The new criteria were set both to express the essence of this disease associated with a rapid increase of the patients' blood glucose and to be highly sensitive to reduce the misdiagnosis. After analyzing the data of 382 patients with newly-diagnosed fulminant type 1 diabetes, we adopted a HbA1c level of 8.7 % (NGSP value) as the cut-off value. The new criterion had 100 % sensitivity and the best value by the ROC (receiver operation curve) analysis.
In addition, we added a comment that "This value (HbA1c <8.7 % in NGSP) is not applicable for patients with previously diagnosed glucose intolerance" to the new criteria, and also a comment that "An association with HLA DRB1^*04: 05-DQB1^*04: 01 has been reported" as a related finding.
We did not revise the screening criteria or the other parts of the diagnostic criteria, because they are still reliable.