Classification of type 1 diabetes: A pathogenic and treatment-based classification

Shivani K Patel; Spiros Fourlanos; Jerry R Greenfield

doi:10.1016/j.dsx.2024.102986

Classification of type 1 diabetes: A pathogenic and treatment-based classification

Diabetes Metab Syndr. 2024 Mar 14;18(3):102986. doi: 10.1016/j.dsx.2024.102986. Online ahead of print.

Authors

Shivani K Patel¹, Spiros Fourlanos², Jerry R Greenfield³

Affiliations

¹ Clinical Diabetes, Appetite and Metabolism Laboratory, Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, St Vincent's Hospital, Sydney, NSW, Australia; School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia. Electronic address: s.patel@garvan.org.au.
² Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
³ Clinical Diabetes, Appetite and Metabolism Laboratory, Garvan Institute of Medical Research, Sydney, NSW, Australia; Department of Diabetes and Endocrinology, St Vincent's Hospital, Sydney, NSW, Australia; School of Clinical Medicine, UNSW Medicine & Health, St Vincent's Healthcare Clinical Campus, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.

PMID: 38503115
DOI: 10.1016/j.dsx.2024.102986

Abstract

Aim: To improve the diagnosis and classification of patients who fail to satisfy current type 1 diabetes diagnostic criteria.

Methods: Review of the literature and current diagnostic guidelines.

Discussion: We propose a novel, clinically useful classification based on islet autoantibody status and non-fasting C-peptide levels. Notably, we discuss the subgroup of latent autoimmune diabetes in the young and propose a new subgroup classification of autoantibody negative type 1 diabetes in remission.

Conclusion: A novel classification system is proposed. Further work is needed to accurately diagnose and manage minority type 1 diabetes subgroups.

Keywords: Atypical diabetes; Autoantibody negative type 1 diabetes; Diabetes classification; Misclassification.