Diagnosis and Classification of Diabetes Mellitus
Open accessAbstract
MELLITUS -Diabetes mellitus 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 various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.Several pathogenic processes are involved in the development of diabetes.These range from autoimmune destruction of the -cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action.The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is deficient action of insulin on target tissues.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.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.Symptoms of marked hyperglycemia include polyuria, polydipsia, weight loss, sometimes with polyphagia, and blurred vision.Impairment of growth and susceptibility to certain infections may also accompany chronic hyperglycemia.Acute, life-threatening consequences of uncontrolled diabetes are hyperglycemia with ketoacidosis or the nonketotic hyperosmolar syndrome.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 gastrointes-
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Claims the paper makes
1 of 49 cited sources checked · 0 supported · 0 flagged · accuracy not yet measured
- Findingcitation
One and usually more autoantibodies are present in 85-90% of individuals when fasting hyperglycemia is initially detected.
“One and usually more of these autoantibodies are present in 85-90% of individuals when fasting hyperglycemia is initially detected.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003) source
Semantic Scholar found a record for the 1997 Expert Committee report, but three searches within that paper returned no snippets verifying the 85–90% figure. An unscoped search found a related statement in “An Updated Review of Type 1 Diabetes in Malaysia” (score 0.548), but not the quoted wording or a sufficiently strong match to establish a different source. The available evidence therefore neither confirms the attribution nor supports a misattribution verdict. (LLM, conf=0.58)
Experimental — accuracy not yet measured
- Findingnone given
In insulin-resistant lipoatrophic diabetes, alterations in the structure and function of the insulin receptor cannot be demonstrated.
“Alterations in the structure and function of the insulin receptor cannot be demonstrated in patients with insulinresistant lipoatrophic diabetes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
Not checked in the free run.
- The authors state this as an assumption: In insulin-resistant lipoatrophic diabetes, the lesion responsible resides in the postreceptor signal transduction pathways.
- Premisecitation
Certain viruses have been associated with beta-cell destruction, including congenital rubella, coxsackievirus B, cytomegalovirus, adenovirus, and mumps.
“Certain viruses have been associated with -cell destruction.Diabetes occurs in patients with congenital rubella, although most of these patients have HLA and immune markers characteristic of type 1 diabetes.In addition, coxsackievirus B, cytomegalovirus, adenovirus, and mumps have been implicated in inducing certain cases of the disease.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Any process that diffusely injures the pancreas can cause diabetes.
“Any process that diffusely injures the pancreas can cause diabetes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
The risk of developing type 2 diabetes increases with age, obesity, and lack of physical activity.
“The risk of developing this form of diabetes increases with age, obesity, and lack of physical activity.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
“The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
In type 1 diabetes, the rate of beta-cell destruction varies, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults).
“In this form of diabetes, the rate of -cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
The vast majority of diabetes cases fall into two broad etiopathogenetic categories.
“The vast majority of cases of diabetes fall into two broad etiopathogenetic categories”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Type 1 diabetes is caused by an absolute deficiency of insulin secretion.
“In one category, type 1 diabetes, the cause is an absolute deficiency of insulin secretion.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Many genetic syndromes are accompanied by an increased incidence of diabetes, including Down, Klinefelter, Turner, and Wolfram syndromes.
“Many genetic syndromes are accompanied by an increased incidence of diabetes mellitus.These include the chromosomal abnorm a l i t i e s o f D o w n ' s s y n d r o m e , Klinefelter's syndrome, and Turner's syndrome.Wolfram's syndrome is an autosomal recessive disorder characterized by insulin-deficient diabetes and the absence of -cells at autopsy.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Point mutations in mitochondrial DNA are associated with diabetes mellitus and deafness.
“Point mutations in mitochondrial DNA have been found to be associated with diabetes mellitus and deafness”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
The most common MODY form is associated with mutations on chromosome 12 in the hepatic transcription factor HNF-1alpha.
“The most common form is associated with mutations on chromosome 12 in a hepatic transcription factor referred to as hepatocyte nuclear factor (HNF)-1␣.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Interpretationreasoning
Glucokinase serves as the glucose sensor for the beta-cell.
“Thus, glucokinase serves as the “glucose sensor” for the -cell.”
Quote in the paperNot a substantial claim - Premisenone given
Type 2 diabetes is often associated with a strong genetic predisposition, more so than autoimmune type 1 diabetes.
“It is often associated with a strong genetic predisposition, more so than is the autoimmune form of type 1 diabetes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Type 2 diabetes is caused by a combination of resistance to insulin action and an inadequate compensatory insulin secretory response.
“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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
A second MODY form is associated with mutations in the glucokinase gene on chromosome 7p and results in a defective glucokinase molecule.
“A second form is associated with mutations in the glucokinase gene on chromosome 7p and results in a defective glucokinase molecule.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Abnormalities at six genetic loci on different chromosomes have been identified for MODY.
“Abnormalities at six genetic loci on different chromosomes have been identified to date.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisenone given
Patients with type 2 diabetes are at increased risk of developing macrovascular and microvascular complications.
“Nevertheless, such patients are at increased risk of developing macrovascular and microvascular complications.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
Some type 1 diabetes patients, particularly children and adolescents, may present with ketoacidosis as the first manifestation of the disease.
“Some patients, particularly children and adolescents, may present with ketoacidosis as the first manifestation of the disease.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Premisecitation
In the absence of pregnancy, IFG and IGT are not clinical entities in their own right but risk factors for future diabetes and cardiovascular disease.
“In the absence of pregnancy, IFG and IGT are not clinical entities in their own right but rather risk factors for future diabetes as well as cardiovascular disease.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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- Premisecitation
Deterioration of glucose tolerance occurs normally during pregnancy, particularly in the third trimester.
“Deterioration of glucose tolerance occurs normally during pregnancy, particularly in the 3rd trimester.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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- Rests on an assumption: Glucose tolerance normally deteriorates during pregnancy, especially in the third trimester.
- Premisecitation
IFG and IGT are associated with the metabolic syndrome, which includes obesity (especially abdominal or visceral), dyslipidemia of the high-triglyceride and/or low-HDL type, and hypertension.
“IFG and IGT are associated with the metabolic syndrome, which includes obesity (especially abdominal or visceral obesity), dyslipidemia of the high-triglyceride and/or low-HDL type, and hypertension.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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- Premisecitation
Diagnostic criteria for the 100-g OGTT are derived from the original work of O'Sullivan and Mahan modified by Carpenter and Coustan.
“Diagnostic criteria for the 100-g OGTT are derived from the original work of O'Sullivan and Mahan (4) modified by Carpenter and Coustan (3) and are shown in the top of Table 3.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites O'Sullivan and Mahan (4) O’Sullivan JB, Mahan CM: Criteria for the oral glucose tolerance test in pregnancy. Diabetes 13:278, 1964 source
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- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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- Classified as probably not a substantial claim. 17
- May combine two claims. 21
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FindingcitationImmune-mediated type 1 diabetes accounts for only 5-10% of people with diabetes.
“This form of diabetes, which accounts for only 5-10% of those with diabetes”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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FindingcitationType 2 diabetes accounts for about 90-95% of people with diabetes.
“This form of diabetes, which accounts for ϳ90 -95% of those with diabetes”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationGDM complicates about 4% of all pregnancies in the U.S., resulting in about 135,000 cases annually.
“GDM complicates ϳ4% of all pregnancies in the U.S., resulting in ϳ135,000 cases annually.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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FindingcitationGDM represents nearly 90% of all pregnancies complicated by diabetes.
“GDM represents nearly 90% of all pregnancies complicated by diabetes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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FindingcitationWhen the two-step approach is used, a glucose threshold above 140 mg/dl identifies about 80% of women with GDM, and the yield increases to 90% with a cutoff above 130 mg/dl.
“When the two-step approach is used, a glucose threshold value Ͼ140 mg/dl (7.8 mmol/l) identifies ϳ80% of women with GDM, and the yield is further increased to 90% by using a cutoff of Ͼ130 mg/dl (7.2 mmol/l).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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FindingcitationGDM prevalence ranges from 1 to 14% of pregnancies depending on the population studied.
“The prevalence may range from 1 to 14% of pregnancies, depending on the population studied.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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PremisecitationMODY forms are characterized by onset of hyperglycemia generally before age 25, impaired insulin secretion with minimal or no defects in insulin action, and autosomal dominant inheritance.
“These forms of diabetes are frequently characterized by onset of hyperglycemia at an early age (generally before age 25 years).They are referred to as maturityonset diabetes of the young (MODY) and are characterized by impaired insulin secretion with minimal or no defects in insulin action.They are inherited in an autosomal dominant pattern.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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PremisecitationDiabetes mellitus is a group of metabolic diseases marked by hyperglycemia caused by defects in insulin secretion, insulin action, or both.
“Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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May combine two claims.
PremisereasoningType 2 diabetes frequently goes undiagnosed for many years because hyperglycemia develops gradually and early stages often lack classic symptoms.
“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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationStiff-man syndrome is an autoimmune CNS disorder; patients usually have high GAD autoantibody titers, and about one-third develop diabetes.
“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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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May combine two claims.
PremisecitationSeveral hormones such as growth hormone, cortisol, glucagon, and epinephrine antagonize insulin action, and excess amounts can cause diabetes.
“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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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May combine two claims.
PremisecitationAnti-insulin receptor antibodies can cause diabetes by blocking insulin binding, and in some cases they act as insulin agonists and cause hypoglycemia.
“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.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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InterpretationreasoningIn type 2 diabetes, insulin secretion is defective and insufficient to compensate for insulin resistance.
“Thus, insulin secretion is defective in these patients and insufficient to compensate for insulin resistance.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationGDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.
“GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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Premisenone givenType 1 diabetes has strong HLA associations, with linkage to the DQA and DQB genes and influence of the DRB genes.
“Also, the disease has strong HLA associations, with linkage to the DQA and DQB genes, and it is influenced by the DRB genes.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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PremisecitationImmune-mediated diabetes commonly occurs in childhood and adolescence but can occur at any age, even in the 8th and 9th decades of life.
“Immunemediated diabetes commonly occurs in childhood and adolescence, but it can occur at any age, even in the 8th and 9th decades of life.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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May combine two claims.
PremisecitationMany drugs can impair insulin secretion and may precipitate diabetes in individuals with insulin resistance.
“Many drugs can impair insulin secretion.These drugs may not cause diabetes by themselves, but they may precipitate diabetes in individuals with insulin resistance.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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Premisenone givenType 2 diabetes occurs more frequently in women with prior gestational diabetes and in individuals with hypertension or dyslipidemia.
“It occurs more frequently in women with prior GDM and in individuals with hypertension or dyslipidemia”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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PremisecitationMost patients with type 2 diabetes are obese, and obesity itself causes some degree of insulin resistance.
“Most patients with this form of diabetes are obese, and obesity itself causes some degree of insulin resistance.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee on the Diagnosis and Classification of Diabetes (Diabetes Care 20:1183-1197, 1997, and Diabetes Care 26:3160 -3167, 2003)
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PremisecitationThe Expert Committee recognized an intermediate group whose glucose levels are too high to be normal but do not meet diabetes criteria.
“The Expert Committee (1,2) recognized an intermediate group of subjects whose glucose levels, although not meeting criteria for diabetes, are nevertheless too high to be considered normal.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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Study design and conductcitationDiagnosis can alternatively be made using a 75-g glucose load and the listed threshold values, but this test is not as well validated as the 100-g OGTT.
“Alternatively, the diagnosis can be made using a 75-g glucose load and the glucose threshold values listed for fasting, 1 h, and 2 h (Table 2, bottom); however, this test is not as well validated as the 100-g OGTT.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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Classified as probably not a substantial claim. May combine two claims.
PremisecitationA fasting plasma glucose level above 126 mg/dl or a casual plasma glucose above 200 mg/dl meets the threshold for the diagnosis of diabetes.
“A fasting plasma glucose level Ͼ126 mg/dl (7.0 mmol/l) or a casual plasma glucose Ͼ200 mg/dl (11.1 mmol/l) meets the threshold for the diagnosis of diabetes.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
InterpretationreasoningPatients with IFG and/or IGT are referred to as having pre-diabetes, indicating a relatively high risk for developing diabetes.
“Patients with IFG and/or IGT are now referred to as having “pre-diabetes” indicating the relatively high risk for development of diabetes in these patients.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationThe criteria for abnormal glucose tolerance in pregnancy are those of Carpenter and Coustan.
“The criteria for abnormal glucose tolerance in pregnancy are those of Carpenter and Coustan (3).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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Classified as probably not a substantial claim. May combine two claims.
Study design and conductnone givenThree ways to diagnose diabetes are possible, and each, in the absence of unequivocal hyperglycemia, must be confirmed on a subsequent day by any one of the three methods.
“Three ways to diagnose diabetes are possible, and each, in the absence of unequivocal hyperglycemia, must be confirmed, on a subsequent day, by any one of the three methods given in Table 2.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationMedical nutrition therapy aimed at 5-10% body weight loss, exercise, and certain pharmacological agents have variably been demonstrated to prevent or delay diabetes in people with IGT; the impact on cardiovascular risk has not been examined.
“It is worth mentioning that medical nutrition therapy aimed at producing 5-10% loss of body weight, exercise, and certain pharmacological agents have been variably demonstrated to prevent or delay the development of diabetes in people with IGT; the potential impact of such interventions to reduce cardiovascular risk has not been examined to date.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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Classified as probably not a substantial claim. May combine two claims.
PremisecitationIGT is defined as 2-h postload glucose 140-199 mg/dl (7.8-11.1 mmol/l), with values below 140 normal and values at least 200 mg/dl a provisional diabetes diagnosis.
“The corresponding categories when the OGTT is used are the following: • 2-h postload glucose Ͻ140 mg/dl (7.8 mmol/l) ϭ normal glucose tolerance; • 2-h postload glucose 140 -199 mg/dl (7.8 -11.1 mmol/l) ϭ IGT (impaired glucose tolerance); • 2-h postload glucose Ն200 mg/dl (11.1 mmol/l) ϭ provisional diagnosis of di-abetes (the diagnosis must be confirmed, as described below).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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Classified as probably not a substantial claim. May combine two claims.
PremisecitationIFG is defined as fasting plasma glucose 100-125 mg/dl (5.6-6.9 mmol/l), with FPG below 100 normal and FPG at least 126 mg/dl a provisional diabetes diagnosis.
“This group is defined as having fasting plasma glucose (FPG) levels Ն100 mg/dl (5.6 mmol/l) but Ͻ126 mg/dl (7.0 mmol/l) or 2-h values in the oral glucose tolerance test (OGTT) of Ն140 mg/dl (7.8 mmol/l) but Ͻ200 mg/dl (11.1 mmol/l).Thus, the categories of FPG values are as follows: • FPG Ͻ100 mg/dl (5.6 mmol/l) ϭ normal fasting glucose; • FPG 100 -125 mg/dl (5.6 -6.9 mmol/ l) ϭ IFG (impaired fast”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Expert Committee (1,2)
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Probably not a substantial claim: may not pass S4 (based). May combine two claims.
Interpretationnone givenCertain factors place women at lower risk for glucose intolerance during pregnancy, and it is likely not cost-effective to screen such patients.
“However, there are certain factors that place women at lower risk for the development of glucose intolerance during pregnancy, and it is likely not costeffective to screen such patients.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationFor the 100-g OGTT, two or more venous plasma concentrations must be met or exceeded for a positive GDM diagnosis.
“Two or more of the venous plasma concentrations must be met or exceeded for a positive diagnosis.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Carpenter and Coustan (3) Carpenter MW, Coustan DR: Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol 144:768–773, 1982 source
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The authors state this as an assumption.
In insulin-resistant lipoatrophic diabetes, the lesion responsible resides 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.
Glucose tolerance normally deteriorates during pregnancy, especially in the third trimester.
“Deterioration of glucose tolerance occurs normally during pregnancy, particularly in the 3rd trimester.”
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?
Several professional organizations have recommended screening most pregnant women for gestational diabetes despite little evidence that identifying and treating mild carbohydrate intolerance confers benefit.
“Several professional organizations have recommended screening for gestational diabetes mellitus for most pregnant women despite little evidence that the identification and treatment of mild carbohydrate intolerance during pregnancy confer a benefit.1,7”
From A Multicenter, Randomized Trial of Treatment for Mild Gestational Diabetes (2009) · cites this paper as [1]
The “Diagnosis of GDM” section recommends testing women at average or high risk and says that earlier recommendations called for screening all pregnancies. It does not assess whether identifying and treating mild carbohydrate intolerance confers benefit, or establish recommendations by several professional organizations. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Pregnancy glucose cutoffs exclude values accepted by Table 2
MinorThe pregnancy-diagnosis paragraph uses strict greater-than cutoffs, while Table 2 accepts values at or above the same numbers. A fasting value of exactly 126 mg/dl-or a casual value of exactly 200 mg/dl with symptoms-therefore meets the table's criterion but not the paragraph's stated cutoff.
“A fasting plasma glucose level Ͼ126 mg/dl (7.0 mmol/l) or a casual plasma glucose Ͼ200 mg/dl (11.1 mmol/l) meets the threshold for the diagnosis of diabetes.”
“Table 2-Criteria for the diagnosis of diabetes mellitus 1. Symptoms of diabetes plus casual plasma glucose concentration Ն200 mg/dl (11.1 mmol/ l).”
GDM thresholds are attributed to the wrong table
MinorThe stated fasting, 1-hour, and 2-hour thresholds for the 75-g GDM test appear in Table 3, not at the bottom of Table 2. Table 2 instead gives a single 2-hour threshold for diagnosing diabetes.
“the glucose threshold values listed for fasting, 1 h, and 2 h (Table 2, bottom)”
“Table 3-Diagnosis of GDM with a 100-g or 75-g glucose load mg/dl mmol/l 100-g glucose load Fasting 95 5.3 1-h 180 10.0 2-h 155 8.6 3-h 140 7.8 75-g glucose load Fasting 95 5.3 1-h 180 10.0 2-h 155 8.6”
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- Authors
- American Diabetes Association
- Corresponding author
- American Diabetes Association
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2006-01-01
- Volume
- 29
- Issue
- suppl_1
- Pages
- s43-s48
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4205321574
- Cited by
- 924
- References
- 4
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 17 · 2023: 30 · 2022: 45 · 2021: 32 · 2020: 34 · 2019: 21 · 2018: 47 · 2017: 44 · 2016: 27 · 2015: 43 · 2014: 57 · 2013: 43 · 2012: 44
- FWCI
- 65.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes mellitus, diagnosis, classification, hyperglycemia, insulin secretion, insulin resistance, islet autoimmunity, diabetes complications, diabetic ketoacidosis, retinopathy, kidney disease, peripheral neuropathy, autonomic neuropathy
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.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-09-28.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.
Statistics and arithmetic are recomputed, not judged.
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