The classification of diabetes mellitus: a conceptual framework.

Diabetes is the extreme manifestation of a spectrum conditions in which the balance of insulin secretion and insulin action (or insulin resistance) has been altered. Loss of euglycemia is caused by relative insulin deficiency in the presence of insulin resistance, or by absolute insulin deficiency. There are related conditions in which an alteration of insulin resistance or beta-cell dysfunction exists, but because of compensation glucose homeostasis has not been lost. The elucidation of the causes of insulin resistance and -cell failure and the attention to the different degrees of insulin deficiency and insulin resistance allow for better diagnosis, treatment, and prevention of diabetes and its related conditions.