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Diagnosis and Classification of Diabetes Mellitus
Open accessAbstract
DIABETESMELLITUSdDiabetes is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
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TL;DR
This ADA position statement reviews the definition, classification, and diagnostic criteria for diabetes and prediabetes, emphasizing type 1, type 2, other specific types, and gestational diabetes mellitus (GDM). It affirms glucose- and A1C-based diagnostic thresholds and recommends updated IADPSG criteria for GDM.
Key findings
- Diabetes is classified into type 1 (5–10% of cases), type 2 (∼90–95%), other specific types, and GDM; immune-mediated type 1 diabetes shows one or more autoantibodies in 85–90% of individuals when fasting hyperglycemia is initially detected.
- Diagnostic criteria include FPG ≥126 mg/dl (7.0 mmol/l), 2-h PG ≥200 mg/dl (11.1 mmol/l) during a 75-g OGTT, or A1C ≥6.5%; random plasma glucose ≥200 mg/dl (11.1 mmol/l) can diagnose diabetes in patients with classic hyperglycemic symptoms or hyperglycemic crisis.
- Prediabetes/increased risk is defined as IFG 100–125 mg/dl (5.6–6.9 mmol/l), IGT 140–199 mg/dl (7.8–11.0 mmol/l), or A1C 5.7–6.4%; A1C 6.0–6.5% carries a 5-year diabetes risk of 25–50% and relative risk 20 times higher than A1C 5.0%.
- GDM affects approximately 7% of pregnancies (range 1–14% depending on population and tests); IADPSG recommends a 75-g OGTT at 24–28 weeks, with GDM diagnosed if any value is exceeded: fasting ≥92 mg/dl (5.1 mmol/l), 1 h ≥180 mg/dl (10.0 mmol/l), or 2 h ≥153 mg/dl (8.5 mmol/l).
Methods
- This is an ADA clinical/consensus statement that synthesizes prior Expert Committee reports, International Expert Committee recommendations, IADPSG guidance, and epidemiologic evidence to define diabetes classification and diagnostic thresholds.
- Evidence cited includes cross-sectional retinopathy studies, NHANES analyses, the Diabetes Prevention Program, a systematic review of 44,203 individuals from 16 cohort studies with mean follow-up 5.6 years, and the HAPO study of ∼25,000 pregnant women.
- Main analysis is narrative synthesis and expert consensus; no new primary data are reported.
Limitations
- The paper states that few randomized clinical trial data exist for treating women newly diagnosed with GDM by only one abnormal glucose value, and that additional well-designed clinical studies are needed to determine optimal monitoring and treatment intensity.
- The paper states A1C diagnostic limitations: greater cost, limited availability in some developing regions, incomplete correlation with average glucose in certain individuals, and misleading results in anemia and hemoglobinopathies; point-of-care A1C assays are not sufficiently accurate for diagnosis.
- The text makes evident that this is a consensus/guideline document rather than a systematic review, and it notes imperfect concordance among FPG, 2-h PG, and A1C, with discordant results requiring repeat/confirmatory testing.
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In the paper
“The most common genetic defect causing transient disease is a defect on ZAC/HYAMI imprinting, whereas permanent neonatal diabetes is most commonly a defect in the gene encoding the Kir6.2 subunit of the β-cell KATP channel.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“The degree of hyperglycemia (if any) may change over time, depending on the extent of the underlying disease process (Fig. 1).”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“Diabetes diagnosed in the first 6 months of life has been shown not to be typical autoimmune type 1 diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“Several forms of diabetes are associated with monogenetic defects in β-cell function.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“This form of diabetes frequently goes undiagnosed for many years because the hyperglycemia develops gradually and at earlier stages is often not severe enough for the patient to notice any of the classic symptoms of diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This so-called neonatal diabetes can either be transient or permanent.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“A second form is associated with mutations in the glucokinase gene on chromosome 7p and results in a defective glucokinase molecule.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“The same disease process can cause impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) without fulfilling the criteria for the diagnosis of diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“In this form of diabetes, the rate of β-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults).”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“With the exception of that caused by cancer, damage to the pancreas must be extensive for diabetes to occur; adrenocarcinomas that involve only a small portion of the pancreas have been associated with diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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- Probably not a substantial claim. 52
- It may state two separate claims as one. 36
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In the paper
“These patients are also prone to other autoimmune disorders such as Graves' disease, Hashimoto's thyroiditis, Addison's disease, vitiligo, celiac sprue, autoimmune hepatitis, myasthenia gravis, and pernicious anemia.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
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In the paper
“Nevertheless, such patients are at increased risk of developing macrovascular and microvascular complications.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
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In the paper
“It is often associated with a strong genetic predisposition, more so than is the autoimmune form of type 1 diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Strength:boosted· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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In the paper
“Also, the disease has strong HLA associations, with linkage to the DQA and DQB genes, and it is influenced by the DRB genes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
Strength:boosted· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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In the paper
“This form of diabetes, which accounts for ∼90–95% of those with diabetes, previously referred to as non–insulin-dependent diabetes, type 2 diabetes, or adult-onset diabetes, encompasses individuals who have insulin resistance and usually have relative (rather than absolute) insulin deficiency”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
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In the paper
“One and usually more of these autoantibodies are present in 85–90% of individuals when fasting hyperglycemia is initially detected.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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In the paper
“During this asymptomatic period, it is possible to demonstrate an abnormality in carbohydrate metabolism by measurement of plasma glucose in the fasting state or after a challenge with an oral glucose load or by A1C.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“Patients with diabetes have an increased incidence of atherosclerotic cardiovascular, peripheral arterial, and cerebrovascular disease.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“This form of diabetes, which accounts for only 5–10% of those with diabetes, previously encompassed by the terms insulin-dependent diabetes or juvenile-onset diabetes, results from a cellular-mediated autoimmune destruction of the β-cells of the pancreas.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
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In the paper
“They are referred to as maturity-onset diabetes of the young (MODY) and are characterized by impaired insulin secretion with minimal or no defects in insulin action.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“The risk of developing this form of diabetes increases with age, obesity, and lack of physical activity.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
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In the paper
“The most common form is associated with mutations on chromosome 12 in a hepatic transcription factor referred to as hepatocyte nuclear factor (HNF)-1α.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“It occurs more frequently in women with prior GDM and in individuals with hypertension or dyslipidemia, and its frequency varies in different racial/ethnic subgroups.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
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In the paper
“Long-term complications of diabetes include retinopathy with potential loss of vision; nephropathy leading to renal failure; peripheral neuropathy with risk of foot ulcers, amputations, and Charcot joints; and autonomic neuropathy causing gastrointestinal, genitourinary, and cardiovascular symptoms and sexual dysfunction.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“They are inherited in an autosomal dominant pattern.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“Some forms of type 1 diabetes have no known etiologies.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
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In the paper
“This form of diabetes is strongly inherited, lacks immunological evidence for β-cell autoimmunity, and is not HLA associated.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Some of these patients have permanent insulinopenia and are prone to ketoacidosis, but have no evidence of autoimmunity.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
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In the paper
“In the latter category, a degree of hyperglycemia sufficient to cause pathologic and functional changes in various target tissues, but without clinical symptoms, may be present for a long period of time before diabetes is detected.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“At least initially, and often throughout their lifetime, these individuals do not need insulin treatment to survive.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
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In the paper
“The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart, and blood vessels.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“Most patients with this form of diabetes are obese, and obesity itself causes some degree of insulin resistance.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
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In the paper
“Immune-mediated diabetes commonly occurs in childhood and adolescence, but it can occur at any age, even in the 8th and 9th decades of life.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 1 diabetes (β-cell destruction, usually leading to absolute insulin deficiency)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Individuals with extensive β-cell destruction and therefore no residual insulin secretion require insulin for survival.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
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In the paper
“Although most cases resolve with delivery, the definition applied whether or not the condition persisted after pregnancy and did not exclude the possibility that unrecognized glucose intolerance may have antedated or begun concomitantly with the pregnancy.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > GDM
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In the paper
“linear regression analyses of these data indicate that among the nondiabetic adult population, an FPG of 110 mg/dl (6.1 mmol/l) corresponds to an A1C of 5.6%, while an FPG of 100 mg/dl (5.6 mmol/l) corresponds to an A1C of 5.4% (R.T. Ackerman, personal communication).”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
What the sources say
- Not checked yetcites R.T. Ackerman, personal communication
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In the paper
“Certain viruses have been associated with β-cell destruction.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The diagnostic A1C cut point of 6.5% is associated with an inflection point for retinopathy prevalence, as are the diagnostic thresholds for FPG and 2-h PG (3).”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
What the sources say
- Not checked yetcites [3] International Expert Committee, 2009, International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes, Diabetes Care source
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In the paper
“Patients receiving α-interferon have been reported to develop diabetes associated with islet cell antibodies and, in certain instances, severe insulin deficiency.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
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In the paper
“Wolfram syndrome is an autosomal recessive disorder characterized by insulin-deficient diabetes and the absence of β-cells at autopsy.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“If extensive enough, cystic fibrosis and hemochromatosis will also damage β-cells and impair insulin secretion.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear? Based: unclearIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Leprechaunism and the Rabson-Mendenhall syndrome are two pediatric syndromes that have mutations in the insulin receptor gene with subsequent alterations in insulin receptor function and extreme insulin resistance.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Similarly, the production of mutant insulin molecules with resultant impaired receptor binding has also been identified in a few families and is associated with an autosomal inheritance and only mildly impaired or even normal glucose metabolism.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“These studies demonstrated glycemic levels below which there was little prevalent retinopathy and above which the prevalence of retinopathy increased in an apparently linear fashion.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
What the sources say
- Not checked yetcites [1] 1997, Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Diabetes Care source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“An A1C range of 6.0--6.5% had a 5-year risk of developing diabetes between 25 and 50% and relative risk 20 times higher compared with an A1C of 5.0% (10).”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
What the sources say
- Not checked yetcites [10] Zhang, 2010, A1C level and future risk of diabetes: a systematic review, Diabetes Care source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Certain toxins such as Vacor (a rat poison) and intravenous pentamidine can permanently destroy pancreatic β-cells.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The stiff-man syndrome is an autoimmune disorder of the central nervous system characterized by stiffness of the axial muscles with painful spasms. Patients usually have high titers of the GAD autoantibodies, and approximately one-third will develop diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Many genetic syndromes are accompanied by an increased incidence of diabetes. These include the chromosomal abnormalities of Down syndrome, Klinefelter syndrome, and Turner syndrome.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Many drugs can impair insulin secretion. These drugs may not cause diabetes by themselves, but they may precipitate diabetes in individuals with insulin resistance.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Approximately 7% of all pregnancies (ranging from 1 to 14%, depending on the population studied and the diagnostic tests employed) are complicated by GDM, resulting in more than 200,000 cases annually.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > GDM
Strength:plain· not yet calibratedn = 200,000Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Anti-insulin receptor antibodies can cause diabetes by binding to the insulin receptor, thereby blocking the binding of insulin to its receptor in target tissues. However, in some cases, these antibodies can act as an insulin agonist after binding to the receptor and can thereby cause hypoglycemia.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Genetic abnormalities that result in the inability to convert proinsulin to insulin have been identified in a few families, and such traits are inherited in an autosomal dominant pattern. The resultant glucose intolerance is mild.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Point mutations in mitochondrial DNA have been found to be associated with diabetes and deafness”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The metabolic abnormalities associated with mutations of the insulin receptor may range from hyperinsulinemia and modest hyperglycemia to severe diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Diabetes occurs in patients with congenital rubella, although most of these patients have HLA and immune markers characteristic of type 1 diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This generally occurs in individuals with preexisting defects in insulin secretion, and hyperglycemia typically resolves when the hormone excess is resolved.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear? Based: unclearIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In one category, type 1 diabetes, the cause is an absolute deficiency of insulin secretion.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Assigning a type of diabetes to an individual often depends on the circumstances present at the time of diagnosis, and many diabetic individuals do not easily fit into a single class.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This form of diabetes, which accounts for ∼90–95% of those with diabetes, previously referred to as non–insulin-dependent diabetes, type 2 diabetes, or adult-onset diabetes, encompasses individuals who have insulin resistance and usually have relative (rather than absolute) insulin deficiency”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The vast majority of cases of diabetes fall into two broad etiopathogenetic categories (discussed in greater detail below).”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the β-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, insulin secretion is defective in these patients and insufficient to compensate for insulin resistance.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Type 2 diabetes (ranging from predominantly insulin resistance with relative insulin deficiency to predominantly an insulin secretory defect with insulin resistance)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In the other, much more prevalent category, type 2 diabetes, the cause is a combination of resistance to insulin action and an inadequate compensatory insulin secretory response.”
§ Diagnosis and Classification of Diabetes Mellitus > DEFINITION AND DESCRIPTION OF DIABETES MELLITUS
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Several hormones (e.g., growth hormone, cortisol, glucagon, epinephrine) antagonize insulin action. Excess amounts of these hormones (e.g., acromegaly, Cushing's syndrome, glucagonoma, pheochromocytoma, respectively) can cause diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > Other specific types of diabetes
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“For many years, GDM has been defined as any degree of glucose intolerance with onset or first recognition during pregnancy.”
§ Diagnosis and Classification of Diabetes Mellitus > CLASSIFICATION OF DIABETES MELLITUS AND OTHER CATEGORIES OF GLUCOSE REGULATION > GDM
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In their recent report (3), an International Expert Committee, after an extensive review of both established and emerging epidemiological evidence, recommended the use of the A1C test to diagnose diabetes, with a threshold of ≥6.5%, and ADA affirms this decision.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
What the sources say
- Not checked yetcites [3] International Expert Committee, 2009, International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes, Diabetes Care source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A1C is a widely used marker of chronic glycemia, reflecting average blood glucose levels over a 2- to 3-month period of time.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The established glucose criteria for the diagnosis of diabetes remain valid. These include the FPG and 2-h PG.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Prior Expert Committees have not recommended use of the A1C for diagnosis of diabetes, in part due to lack of standardization of the assay.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Moreover, the A1C has several advantages to the FPG, including greater convenience, since fasting is not required, evidence to suggest greater preanalytical stability, and less day-to-day perturbations during periods of stress and illness.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The test plays a critical role in the management of the patient with diabetes, since it correlates well with both microvascular and, to a lesser extent, macrovascular complications and is widely used as the standard biomarker for the adequacy of glycemic management.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“It should be noted that the 2003 ADA Expert Committee report reduced the lower FPG cut point to define IFG from 110 mg/dl (6.1 mmol/l) to 100 mg/dl (5.6 mmol/l), in part to ensure that prevalence of IFG was similar to that of IGT.”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
What the sources say
- Not checked yetcites [1] 1997, Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, Diabetes Care source
- Not checked yetcites [2] Genuth, 2003, Follow-up report on the diagnosis of diabetes mellitus, Diabetes Care source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hence, it is reasonable to consider an A1C range of 5.7--6.4% as identifying individuals with high risk for future diabetes, to whom the term prediabetes may be applied.”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As A1C is used more commonly to diagnose diabetes in individuals with risk factors, it will also identify those at higher risk for developing diabetes in the future.”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“IFG and IGT should not be viewed as clinical entities in their own right but rather risk factors for diabetes as well as cardiovascular disease.”
§ Diagnosis and Classification of Diabetes Mellitus > CATEGORIES OF INCREASED RISK FOR DIABETES
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, it is conceivable that the lower sensitivity of A1C at the designated cut point will be offset by the test's greater practicality, and that wider application of a more convenient test (A1C) may actually increase the number of diagnoses made.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Rests on an assumption: In practice, a large portion of the population with type 2 diabetes remains unaware of their condition.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is preferable that the same test be repeated for confirmation, since there will be a greater likelihood of concurrence in this case.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These new criteria will significantly increase the prevalence of GDM, primarily because only one abnormal value, not two, is sufficient to make the diagnosis.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS > Diagnosis of GDM
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Admittedly, in most circumstance the “nondiabetic” test is likely to be in a range very close to the threshold that defines diabetes.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is least likely for A1C, somewhat more likely for FPG, and most likely for the 2-h PG.”
§ Diagnosis and Classification of Diabetes Mellitus > DIAGNOSTIC CRITERIA FOR DIABETES MELLITUS
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear? Based: unclearIt may state two separate claims as one.
The authors state this as an assumption.
In insulin-resistant lipoatrophic diabetes, the lesion(s) must reside in the postreceptor signal transduction pathways.
“Therefore, it is assumed that the lesion(s) must reside in the postreceptor signal transduction pathways.”
The paper relies on this without support.
Structured lifestyle intervention aimed at increasing physical activity and producing 5–10% loss of body weight, and certain pharmacological agents, prevent or delay the development of diabetes in people with IGT.
“Structured lifestyle intervention, aimed at increasing physical activity and producing 5–10% loss of body weight, and certain pharmacological agents have been demonstrated to prevent or delay the development of diabetes in people with IGT; the potential impact of such interventions to reduce mortality or the incidence of cardiovascular disease has not been demonstrated to date.”
The paper relies on this without support.
A1C assays are now highly standardized so that their results can be uniformly applied both temporally and across populations.
“However, A1C assays are now highly standardized so that their results can be uniformly applied both temporally and across populations.”
The paper relies on this without support.
Point-of-care A1C assays are not sufficiently accurate at this time to use for diagnostic purposes.
“Point-of-care A1C assays are not sufficiently accurate at this time to use for diagnostic purposes.”
The paper relies on this without support.
The A1C can be misleading in patients with certain forms of anemia and hemoglobinopathies.
“In addition, the A1C can be misleading in patients with certain forms of anemia and hemoglobinopathies, which may also have unique ethnic or geographic distributions.”
The paper relies on this without support.
In practice, a large portion of the population with type 2 diabetes remains unaware of their condition.
“However, in practice, a large portion of the population with type 2 diabetes remains unaware of their condition.”
The paper relies on this without support.
GDM carries risks for the mother and neonate.
“GDM carries risks for the mother and neonate.”
The paper relies on this without support.
There are few data from randomized clinical trials regarding therapeutic interventions in women who will now be diagnosed with GDM based on only one blood glucose value above the specified cut points.
“Admittedly, there are few data from randomized clinical trials regarding therapeutic interventions in women who will now be diagnosed with GDM based on only one blood glucose value above the specified cut points (in contrast to the older criteria that stipulated at least two abnormal values).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“HbAc levels $.%, suggested for the diagnosis of DM in the general population, may be particularly helpful in the clinical setting of CS because this parameter is an integrated measure of glucose homeostasis ().”
From Glucose Metabolism Abnormalities in Cushing Syndrome: From Molecular Basis to Clinical Management (2017) · cites this paper as [179]
Citations
Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) · Diabetes Care · doi:10.2337/diacare.20.7.1183 · Cited by 6,220
Hyperglycemia and adverse pregnancy outcomes
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Follow-up report on the diagnosis of diabetes mellitus
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International Expert Committee report on the role of the A1c assay in the diagnosis of diabetes
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Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes
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A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes
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“Expected benefits to their pregnancies and offspring is inferred from intervention trials that focused on women with more mild hyperglycemia than identified using older GDM diagnostic criteria and that found modest benefits (15,16).”
BackgroundMetzger, B. E., Gabbe, S. G., Persson, B., Lowe, L. P., Dyer, A. R., Oats, J. J. N., & Buchanan, T. A. (2010) · Diabetes Care · doi:10.2337/dc10-0719 · Cited by 1,888
Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults
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Metadata
- Authors
- American Diabetes Association
- Corresponding author
- American Diabetes Association
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2012-12-10
- Volume
- 36
- Issue
- Supplement_1
- Pages
- S67-S74
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3537273
- OpenAlex
- W4241151929
- Cited by
- 2,245
- References
- 16
- Citations by year
- 2026: 56 · 2025: 122 · 2024: 180 · 2023: 235 · 2022: 250 · 2021: 191 · 2020: 180 · 2019: 132 · 2018: 108 · 2017: 121 · 2016: 150 · 2015: 198 · 2014: 212 · 2013: 99 · 2012: 6
- FWCI
- 132.43
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Keywords
- diabetes mellitus, diagnosis, classification, hyperglycemia, insulin secretion, insulin resistance, metabolic disorders, diabetes complications
- MeSH terms
- Diabetes Mellitus, Female, Humans, Male, Pregnancy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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