Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO Consultation

• Published in: Diabetic medicine 1998-07, Vol.15 (7), p.539-553
• Main Authors: Alberti, K.G.M.M., Zimmet, P.Z.
• Format: Article
• Language: English
• Subjects: Autoimmune Diseases; Biological and medical sciences; Blood Glucose - analysis; classification; diabetes mellitus; Diabetes Mellitus - classification; Diabetes Mellitus - diagnosis; Diabetes Mellitus - etiology; Diabetes, Gestational - classification; Diabetes, Gestational - diagnosis; Diabetes. Impaired glucose tolerance; diagnosis; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; gestational diabetes mellitus; Glucose Intolerance; Glucose Tolerance Test; Humans; Insulin Resistance; Islets of Langerhans - immunology; Islets of Langerhans - pathology; Medical sciences; Mutation; Pregnancy; Reference Values; Type 1 diabetes; Type 2 diabetes; World Health Organization
• ISSN: 0742-3071; 1096-9136; 1464-5491
• DOI: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S

The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re‐examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to ≥7.0 mmol l−1 (6.1 mmol l−1). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut‐off for diabetes (plasma ≥6.1 to