A) immune mediated * (B) idiopathic of diagnostic testing. I understand that an initial proposal, to create a category of auto-immune diabetes based on Type 2 diabetes mellitus auto-antibody screening, found support in high-tech, ranging from predominantly insulin resistant with relative insulin high-cost Occidentialism but such a category would deficiency to predominantly an insulin secretory defect with insuhave been unusable in most areas of the world and the lin resistance. categorisation of Type 1 diabetes mellitus will remain, Other specific types for most of us, a question of clinical recognition of * genetic defects in Γ cell function insulin deficiency and ketosis prone disease. Allocation * genetic defects in insulin action to Type 1A or 1B will be a matter for choice based on * disease of the exocrine pancreas * endocrinopathics clinical or academic need to know and availability of * drug or chemical induced diagnostic tests. It seems likely to this reviewer that * infection induced category B patients may dwindle as new islet antigens * uncommon forms of immune related diabetes and autoantibodies are uncovered, although non-immune * other genetic syndromes aetiology remains likely in at least some of the 80% of Gestational diabetes mellitus Africans for example with antibody negative clinical Type 1 disease. It is incidentally important to realise that the committee viewed each category of diabetes as a continuum with people moving from normoglycaemia, References through IGT and IFG, to diabetes mellitus which does not require insulin, diabetes mellitus requiring insulin 1. Expert Committee on the Diagnosis and Classification of for control and exclusively. Diabetes Mellitus. Report of the Expert Committee on the A meeting of minds was clear in the ADA conference Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997; 20.
and consensus with the WHO seems a likely, and hugely