Kosaka K
Toranomon Hospital, Tokyo, Japan.
Diabetes Res Clin Pract. 1994 Oct;24 Suppl:S59-62. doi: 10.1016/0168-8227(94)90228-3.
After the proposal of diagnostic criteria for diabetes mellitus by the National Diabetes Data Group (1979) and by WHO (1980), a committee was set up by the Japan Diabetes Society (JDS) to reconsider the old criteria by the JDS which had been proposed in 1970. Items covered by the report of the committee in 1982 included the concept of diabetes mellitus, describing it's features, and stating that it's diagnosis is a procedure of recognizing the disease 'diabetes' characterized by these features. Cutoff blood glucose values for fasting samples, after a 75 g oral glucose tolerance test, were proposed to define normal and diabetic types. The cutoff values for the diabetic type are identical to those of the WHO defining diabetes, whereas the values for the normal type (fasting < 110 mg/dl and 1-h < 160 and 2-h < 120 mg/dl for venous plasma) are much lower than those for the lower limit of IGT by the WHO. Subjects whose glucose tolerance is neither diabetic nor normal are classified as borderline type, which includes not only IGT but cases with milder glucose intolerance. The cutoff points for the normal type were selected based on the long-term follow-up data for mild glucose intolerance in Japan. The Committee further stated that the clinical diagnosis of diabetes should be made not only on the basis of the glucose tolerance data, but also after clinical consideration of the possibility of any other diseases which might impair glucose tolerance.
在美国国家糖尿病数据组(1979年)和世界卫生组织(1980年)提出糖尿病诊断标准后,日本糖尿病学会(JDS)成立了一个委员会,重新审议JDS于1970年提出的旧标准。该委员会1982年报告涵盖的内容包括糖尿病的概念,描述其特征,并指出糖尿病的诊断是一个识别具有这些特征的“糖尿病”疾病的过程。提出了空腹样本以及75克口服葡萄糖耐量试验后血糖的临界值,以界定正常和糖尿病类型。糖尿病类型的临界值与世界卫生组织界定糖尿病的临界值相同,而正常类型的临界值(静脉血浆空腹<110毫克/分升、1小时<160毫克/分升和2小时<120毫克/分升)远低于世界卫生组织糖耐量受损下限的临界值。糖耐量既非糖尿病也非正常的受试者被归类为边缘型,这不仅包括糖耐量受损,还包括葡萄糖不耐受较轻的病例。正常类型的临界值是根据日本轻度葡萄糖不耐受的长期随访数据选定的。该委员会还指出,糖尿病的临床诊断不仅应基于糖耐量数据,还应在临床考虑可能损害糖耐量的任何其他疾病的可能性之后做出。