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Diabetes mellitus is "a group of metabolic disease" characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. New recommendations for the classification and d...iagnostic criteria of diabetes mellitus was proposed by American Diabetes Association(ADA) expert committee and World Health Organization(WHO) consultation group in 1997 and 1998, respectively. In 1999, expert committee on the diagnosis and classification organized by Japan Diabetes Society (JDS), published new guideline recommending etiology-based criteria for the diagnosis of diabetes mellitus. These recommendations include the preferred use of the terms 「Type 1」 and 「Type 2」 instead of "insulin dependent diabetes diabetes (IDDM)" and "non-insulin dependent diabetes mellitus (NIDDM)" to designate the two major types of diabetes. Type 1 diabetes is characterized by beta cell destruction caused by an autoimmune process, usually leading to absolute insulin deficiency. On the other hand, Type 2 diabetes mellitus is characterized by insulin resistance in peripheral tissue and an insulin secretory defect of the beta cell, or both. The etiology of this type is multifactorial and probably genetically based, but it also has strong behavioral components (lifestyle related disease). Type 2 diabetes, the most prevalent from the disease, is often asymptomatic in its early stages and can remain undiagnosed for many years. On the basis of glycemia, diabetic type is defined when fasting plasma glucose(FPG) exceeded 126mg/dl(7mM/L) and 2-hour plasma glucose (PG) by 75g OGTT exceeded 200 mg/dl. Normal type is defined by FPG < 110mg/dl and 2-hour PG < 140mg/dl. In this review, we shall describe the current concepts of new pathophysiological classification and staging process of diabetes続きを見る
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