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)

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  • Imagawa Akihisa
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University Secretariat
  • Hanafusa Toshiaki
    Department of Internal Medicine (I), Osaka Medical College Chairman
  • Awata Takuya
    Department of Endocrinology and Diabetes, Saitama Medical University
  • Ikegami Hiroshi
    Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine
  • Uchigata Yasuko
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Osawa Haruhiko
    Department of Laboratory Medicine, Ehime University School of Medicine
  • Kawasaki Eiji
    Department of Metabolism/Diabetes and Clinical Nutrition, Nagasaki University Hospital
  • Kawabata Yumiko
    Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine
  • Kobayashi Tetsuro
    Third Department of Internal Medicine, University of Yamanashi School of Medicine
  • Shimada Akira
    Department of Internal Medicine, Saiseikai Central Hospital
  • Shimizu Ikki
    Department of Internal Medicine, The Sakakibara Heart Institute of Okayama
  • Takahashi Kazuma
    Department of Diabetes and Metabolism, Iwate Medical University
  • Nagata Masao
    Department of Internal Medicine, Kakogawa Municipal Hospital
  • Makino Hideichi
    Diabetes Center, Shiraishi Hospital
  • Maruyama Taro
    Department of Internal Medicine, Saitama Social Insurance Hospital

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Other Title
  • 1型糖尿病調査研究委員会報告―劇症1型糖尿病の新しい診断基準（2012）
  • イインカイ ホウコク 1ガタ トウニョウビョウ チョウサ ケンキュウ イインカイ ホウコク : ゲキショウ 1ガタ トウニョウビョウ ノ アタラシイ シンダン キジュン(2012)

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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.<br> 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.<br> We did not revise the screening criteria or the other parts of the diagnostic criteria, because they are still reliable.<br>

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