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

Abstract

Type 1 diabetes is characterized by the destruction of pancreatic beta cells, which leads to an absolute deficiency in insulin secretion. Depending on the manner of onset and progression, the disease is classified as fulminant, acute or slowly progressive. We herein propose diagnostic criteria for acute-onset type 1 diabetes mellitus. Among patients who develop ketosis or diabetic ketoacidosis within three months after the onset of hyperglycemic symptoms and require insulin treatment continuously after the diagnosis of diabetes, those 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 (a fasting CPR level of <0.6 ng/ml) without verifiable anti-islet autoantibodies are diagnosed simply with "acute-onset type 1 diabetes mellitus." Patients should therefore be reevaluated after certain periods in cases in which the status of anti-islet autoantibodies and/or endogenous insulin secretion is unknown.