Diagnostic Criteria for Slowly Progressive Insulin-dependent (Type 1) Diabetes Mellitus (SPIDDM) (2012) -Report by the Committee on Slowly Progressive Insulin-dependent (Type 1) Diabetes Mellitus of the Japan Diabetes Society-

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  • Tanaka Shoichiro
    Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
  • Ohmori Masayuki
    Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
  • Awata Takuya
    Department of Endocrinology and Diabetes, Saitama Medical University
  • Shimada Akira
    Department of Internal Medicine, Saiseikai Central Hospital
  • Murao Satoshi
    Department of Diabetes and Endocrinology, Takamatsu Hospital
  • Maruyama Taro
    Department of Internal Medicine, Saitama Social Insurance Hospital
  • Kamoi Kyuzi
    The Diabetes and Endocrine & Metabolism Disease Center, Ojiya General Hospital
  • Kawasaki Eiji
    Department of Metabolism/Diabetes and Clinical Nutrition, Nagasaki University Hospital
  • Nakanishi Koji
    Department of Diabetes, Minami-isshiki Central Clinic
  • Nagata Masao
    Department of Internal Medicine, Kakogawa City West Hospital
  • Fujii Sumie
    Diabetology & Endocrinology, Ishikawa Prefectural Central Hospital
  • Ikegami Hiroshi
    Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine
  • Imagawa Akihisa
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
  • Uchigata Yasuko
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Okubo Minoru
    Department of Endocrinology and Metabolism, Toranomon Hospital
  • Osawa Haruhiko
    Department of Molecular and Genetic Medicine, Ehime University Graduate School of Medicine
  • Kajio Hiroshi
    Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, National Center for Global Health and Medicine Hospital
  • Kawaguchi Akio
    Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi
  • Kawabata Yumiko
    Department of Endocrinology, Metabolism and Diabetes, Kinki University School of Medicine
  • Satoh Jo
    Department of Diabetes and Metabolism, Iwate Medical University
  • Shimizu Ikki
    Department of Diabetic Medicine, The Sakakibara Heart Institute of Okayama
  • Takahashi Kazuma
    Department of Diabetes and Metabolism, Iwate Medical University
  • Makino Hideichi
    Diabetes Center, Shiraishi Hospital
  • Iwahashi Hiromi
    Department of Metabolic Medicine, Graduate School of Medicine, Osaka University
  • Miura Junnosuke
    Diabetes Center, Tokyo Women's Medical University School of Medicine
  • Yasuda Kazuki
    Department of Metabolic Disorder, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine
  • Hanafusa Toshiaki
    Department of Internal Medicine (I), Osaka Medical College
  • Kobayashi Tetsuro
    Third Department of Internal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi Chairman
  • Committee on Type 1 Diabetes

Bibliographic Information

Other Title
  • 緩徐進行1型糖尿病（SPIDDM）の診断基準（2012）―1型糖尿病調査研究委員会（緩徐進行1型糖尿病分科会）報告―
  • 委員会報告 緩徐進行1型糖尿病(SPIDDM)の診断基準(2012) : 1型糖尿病調査研究委員会(緩徐進行1型糖尿病分科会)報告
  • イインカイ ホウコク カンジョ シンコウ 1ガタ トウニョウビョウ(SPIDDM)ノ シンダン キジュン(2012) : 1ガタ トウニョウビョウ チョウサ ケンキュウ イインカイ(カンジョ シンコウ 1ガタ トウニョウビョウ ブンカカイ)ホウコク

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Abstract

Diagnostic criteria for slowly progressive insulin-dependent (type 1) diabetes mellitus (SPIDDM) have been proposed by the Committee on Slowly Progressive Insulin-dependent (Type 1) Diabetes Mellitus of the Japan Diabetes Society. The following two criteria are required for a definitive diagnosis: 1) the presence of glutamic acid decarboxylase antibodies (GADAbs) and/or islet cell antibodies (ICAs) at some time during the patient's clinical course and 2) the absence of ketosis or ketoacidosis at the onset (or diagnosis) of diabetes mellitus without the need for insulin treatment to correct hyperglycemia immediately after diagnosis. It remains unclear whether insulinoma-associated antigen-2 autoantibodies (IA-2Abs), insulin autoantibodies (IAAs) or zinc transporter 8 autoantibodies (ZnT8Abs) are essential markers for the diagnosis of SPIDDM. Hence, the presence of IA-2Abs, IAAs and ZnT8Abs was excluded from the diagnostic criteria for SPIDDM. Furthermore, ketosis and/or ketoacidosis are observed in cases of SPIDDM complicated by soft drink-induced ketosis. Supplementary information for the diagnosis includes the following: 1) most SPIDDM patients require insulin treatment for more than three months after the onset (or diagnosis) of diabetes mellitus and frequently progress to an insulin-dependent state, 2) GADAbs and ICAs become negative during the clinical course in many cases, 3) a small proportion of patients will maintain their endogenous beta cell function, irrespective of the titer of GADAbs and ICAs, over 10 years after the onset (or diagnosis) of diabetes; and 4) sometimes, early insulin treatment is initiated when GADAbs and/or ICAs are positive in both adult and pediatric cases.<br>

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