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2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2022
Open accessAbstract
The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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“Glycemic management is primarily assessed with the HbA1c test, which was the measure used in trials demonstrating the bene fi ts of glucose lowering (2,52).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [52]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Autoantibody markers are usually present in 85% to 90% of individuals with type 1 diabetes when fasting hyperglycemia is initially detected (2).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Chronic diseases, such as T2DM, develop over a long period [102].”
From Digital Health Interventions to Prevent Type 2 Diabetes Mellitus: Systematic Review (2025) · cites this paper as [102]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Overall, 10 of 42 (24%) patients had a 2-hour plasma glucose level ≥140 mg/dL on the oral glucose tolerance test indicative of impaired glucose tolerance according to the World Health Organization (WHO) and the American Diabetes Association.1”
From Pain and small fiber pathology in men with fibromyalgia syndrome (2024) · cites this paper as [1]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“As with any laboratory test, HbA1c measurement has limitations (2,52).”
The cited source says what the claim attributes to it.
In the citing paper
“An HbA 1c value of 6.5% (48 mmol/mol) or greater is considered diagnostic.”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Depending on the specific MODY mutation, the disease can be mild (e.g., glucokinase mutation) and not usually associated with long term complications of diabetes or as severe as typical type 1 diabetes (e.g., hepatocyte nuclear factor [HNF] mutations) (2).”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“responsive to sulfonylureas”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“genitourinary”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“developmental delay and seizures”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“responsive to sulfonylureas”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent or transient: IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“gout”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“HNF1B | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent or transient: IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“HNF1B-MODY”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“atrophy of the pancreas”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“HNF1B-MODY: developmental renal disease”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“KCNJ11 | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“developmental delay”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“ABCC8 | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“insulin requiring”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent: IUGR; insulin requiring”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“hyperuricemia”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“INS | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“medications other than insulin”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“insulin requiring”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“GATA6 | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“EIF2B1 | AD”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“epiphyseal dysplasia”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“mechanisms include UPD6”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“macroglossia”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“EIF2AK3 | AR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“pancreatic exocrine”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“fluctuating liver function”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“pancreatic hypoplasia”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent diabetes”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“cardiac”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“pancreatic exocrine”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent: pancreatic hypoplasia; cardiac”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“immunodysregulation”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“autoimmune diabetes”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“insulin requiring”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent: Wolcott-Rallison syndrome”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“6q24 (PLAGL1, HYMA1) | AD for paternal duplications”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“IUGR”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“FOXP3 | X-linked”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Transient: IUGR; macroglossia; umbilical”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“Permanent: immunodysregulation,”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“hernia”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“insulin requiring”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“exfoliative”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
The cited source says what the claim attributes to it.
In the citing paper
“autoimmune thyroid disease”
From Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus (2023) · cites this paper as [2]
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Citations
Cites
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BackgroundDiagnosis and Classification of Diabetes Mellitus
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Metadata
- Authors
- American Diabetes Association Professional Practice Committee
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-12-16
- Volume
- 45
- Issue
- Supplement_1
- Pages
- S17-S38
- ISSN
- 0149-5992 (ISSN-L)
- OpenAlex
- W4200148796
- Semantic Scholar
- a1d863e5f4d381bf99eea7ee26e18dcc69f81a15
- Cited by
- 4,792
- References
- 253
- Citations by year
- 2026: 293 · 2025: 689 · 2024: 1026 · 2023: 1164 · 2022: 814 · 2021: 356
- FWCI
- 129.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes classification, diabetes diagnosis, diabetes diagnosis criteria, diabetes subtypes
- MeSH terms
- Diabetes Mellitus, Endocrinology, Humans, Reference Standards, Societies, Medical, Standard of Care
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