Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, Saitama, Japan.
Diabetes Center, Shin-Koga Hospital, Fukuoka, Japan.
J Diabetes Investig. 2024 Feb;15(2):254-257. doi: 10.1111/jdi.14121. Epub 2024 Jan 7.
The diagnostic criteria for slowly progressive type 1 diabetes (slowly progressive insulin-dependent diabetes mellitus; SPIDDM) have been revised by the Committee on Type 1 Diabetes of the Japan Diabetes Society. All of the following three criteria must be met for 'a definitive diagnosis of SPIDDM': (1) presence of anti-islet autoantibodies at some point in time during the disease course; (2) absence of ketosis or ketoacidosis at the diagnosis of diabetes with no requirement for insulin treatment to correct hyperglycemia immediately after diagnosis in principle; and (3) gradual decrease of insulin secretion over time, with insulin treatment required at more than 3 months after diagnosis, and the presence of severe endogenous insulin deficiency (fasting serum C-peptide immunoreactivity <0.6 ng/mL) at the last observed point in time. When a patient fulfills only (1) and (2), but not (3), he/she is diagnosed with 'SPIDDM (probable)' because the diabetes is non-insulin-dependent type.
日本糖尿病学会 1 型糖尿病委员会修订了缓慢进展型 1 型糖尿病（缓慢进展型胰岛素依赖型糖尿病；SPIDDM）的诊断标准。符合以下三个标准中的任何三个标准可确诊为“SPIDDM”：（1）在疾病过程中的某个时间点存在胰岛自身抗体；（2）诊断糖尿病时无酮症或酮症酸中毒，原则上无需胰岛素治疗即刻纠正高血糖；（3）随着时间的推移，胰岛素分泌逐渐减少，诊断后 3 个月以上需要胰岛素治疗，且最后一次观察时存在严重的内源性胰岛素缺乏（空腹血清 C 肽免疫反应性 <0.6ng/mL）。当患者仅满足标准 (1) 和 (2)，但不满足标准 (3) 时，由于糖尿病是非胰岛素依赖型，因此被诊断为“SPIDDM（可能）”。
