Testing for autoantibodies to endogenous insulin in addition to regular autoantibody screening can increase the proportion of children with an autoimmune classification for newly diagnosed type 1 diabetes, UK research suggests.

They caution: “We cannot at this stage claim that the new clusters represent different aetiologies of diabetes, nor that this clustering is the optimal classification of diabetes subtypes.”

Measuring C-peptide in everyone a minimum of 3 years after a clinical diagnosis of type 1 diabetes can result in some people being reclassified with other forms of diabetes, researchers report.

Pattou et al conclude: “Our results show the clinical relevance of data­driven classification to inform therapeutic choice, supporting the indication for metabolic surgery in patients with SIRD, and the distinct biological characteristics of this subgroup of patients.”

Jay Shubrook, Chair of the American Diabetes Association’s Primary Care Advisory Group, outlines what's new in 2018's ADA Standards of Care update. 

Diabetes classification and nomenclature Staging of type 1 diabetes: Various genetic and environmental factors can result in the progressive loss of β-cell mass and/or function that manifests clinically as hyperglycemia.

Adding body fat percentage to BMI improves the classification of individuals at risk for abnormal blood glucose, US researchers report.

Similar disorders: ICD-10 and DSM-5 The ICD-10 and DSM-5 include disorders that are similar to, and may overlap with, existing descriptions of diabetes distress.

However, initial classification among people with PPDM was most commonly type 2 diabetes (44.9%) followed by type 1 diabetes (14.2%).

The area under the receiver operating characteristic curves (AUCs) for classification of combined micro- and macrovascular events, and microvascular and macrovascular events alone were 0.67, 0.67, and 0.68, respectively, with the AUC ranging from 0.64 to 0.72 for various specific micro- and macrovascular events .

A study in 2002 , showed that while deaths of people with type 1 diabetes caused by cancer or vascular disease were reliably coded on death certificates, those due to hypoglycemia or ketoacidosis were often not described as such on death certificates nor identifiable by International Classification of Diseases (ICD) code.

Of the 647,099 children born to these women, 5.39% were diagnosed with a psychiatric or mild neurodevelopmental disorder – defined as any International Statistical Classification of Diseases and Related Health Conditions, 10th Revision (ICD-10) F code – at the age of 11 years or younger.

He suggested that inaccurate classification might be an issue.

The AB classification system   A-B+ These patients are mostly like to have ketosis-prone type 2 diabetes.

The 1.5-year difference in time to first event between the low- and high-risk categories in the 40–49 years age category (53,618 people) was also not significant, whereas among those who were older at diabetes diagnosis, high-risk classification was associated with having a CVD event a significant 1.5–2.0 years earlier.

Classification GLP-1 RAs are an injectable class of incretin-based glucose-lowering medications, which include a wide variety of preparations and combinations (Box 1) [1, 2].

In all, 2.4% of the cohort had sleep disturbance according to ICD-10 codes.