Shimada Akira, Kawasaki Eiji, Abiru Norio, Awata Takuya, Oikawa Yoichi, Osawa Haruhiko, Kajio Hiroshi, Kozawa Junji, Takahashi Kazuma, Chujo Daisuke, Noso Shinsuke, Fukui Tomoyasu, Miura Junnosuke, Yasuda Kazuki, Yasuda Hisafumi, Imagawa Akihisa, Ikegami Hiroshi
Department of Endocrinology and Diabetes, School of Medicine, Saitama Medical University, 38 Morohongo, Moroyama, Iruma, Saitama Japan.
Diabetes Center, Shin-Koga Hospital, Fukuoka, Japan.
Diabetol Int. 2024 Jan 8;15(1):1-4. doi: 10.1007/s13340-023-00679-1. eCollection 2024 Jan.
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 of 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 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 the only (1) and (2), but not (3), he/she is diagnosed with "SPIDDM (probable)" because the diabetes is non-insulin-dependent state.
日本糖尿病学会1型糖尿病委员会修订了缓慢进展性1型糖尿病（缓慢进展性胰岛素依赖型糖尿病；SPIDDM）的诊断标准。要“确诊SPIDDM”，必须满足以下所有三项标准：（1）在病程中的某个时间点存在抗胰岛自身抗体；（2）糖尿病诊断时不存在酮症或酮症酸中毒，原则上诊断后无需立即使用胰岛素治疗来纠正高血糖；（3）胰岛素分泌随时间逐渐减少，诊断后3个月以上需要胰岛素治疗，且在最后观察时间点存在严重的内源性胰岛素缺乏（空腹血清C肽免疫反应性<0.6 ng/mL）。当患者仅满足（1）和（2），但不满足（3）时，因其糖尿病处于非胰岛素依赖状态，故诊断为“可能的SPIDDM”。
