Practical Classification Guidelines for Diabetes in patients treated with insulin: a cross-sectional study of the accuracy of diabetes diagnosis

• Published in: British journal of general practice 2016-05, Vol.66 (646), p.e315-e322
• Main Authors: Hope, Suzy V, Wienand-Barnett, Sophie, Shepherd, Maggie, King, Sophie M, Fox, Charles, Khunti, Kamlesh, Oram, Richard A, Knight, Bea A, Hattersley, Andrew T, Jones, Angus G, Shields, Beverley M
• Format: Article
• Language: English
• Subjects: Biomarkers - urine; Body Mass Index; C-Peptide - urine; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Insulin - metabolism; Male; Practice Guidelines as Topic; Reproducibility of Results; ROC Curve; United Kingdom - epidemiology
• ISSN: 0960-1643; 1478-5242
• DOI: 10.3399/bjgp16X684961

Differentiating between type 1 and type 2 diabetes is fundamental to ensuring appropriate management of patients, but can be challenging, especially when treating with insulin. The 2010 UK Practical Classification Guidelines for Diabetes were developed to help make the differentiation. To assess diagnostic accuracy of the UK guidelines against 'gold standard' definitions of type 1 and type 2 diabetes based on measured C-peptide levels. In total, 601 adults with insulin-treated diabetes and diabetes duration ≥5 years were recruited in Devon, Northamptonshire, and Leicestershire. Baseline information and home urine sample were collected. Urinary C-peptide creatinine ratio (UCPCR) measures endogenous insulin production. Gold standard type 1 diabetes was defined as continuous insulin treatment within 3 years of diagnosis and absolute insulin deficiency (UCPCR