There are more classifications, as follows:
Since 1965, the World Health Organization (WHO) has regularly updated its guidelines for classifying diabetes, and 5 versions have been published, including the classic WHO 1999 Diabetes 4 classification, which continues the American Diabetes Association’s 1997 typing and the 16th International Diabetes Federation (IDF) typing scheme, which classifies type 1 diabetes as autoimmune (acute onset This classification has been in use for more than 20 years.
The latest version of the WHO Diabetes Classification, released in 2019, divides diabetes into 6 categories, with a focus on removing the subtypes T1DM and T2DM compared with the previous 4 diabetes subtypes. Previously, T1DM was divided into immune-mediated type 1 and idiopathic type 1 based on the presence or absence of concomitant immunologic indicators. These two groups of T1DM were also previously referred to as type 1A “autoimmune” and type 1B “non-immune” diabetes, but this terminology was not often used and was not clinically helpful. Therefore, the new guidelines refer only to T1DM and no longer include the subtypes used in the WHO 1999 classification.
The Chinese Expert Consensus on Standardized Diagnosis and Treatment of Type 1 Diabetes Mellitus in Children (2020 version) classifies type 1 diabetes mellitus into type 1 diabetes mellitus and fulminant type 1 diabetes mellitus. The purpose of this typing is to allow for targeted treatment.
- Type 1 diabetes has an acute onset, some patients develop ketoacidosis, and tests may reveal decreased reserve function of pancreatic islet beta cells or even functional failure.
- Fulminant type 1 diabetes is seen mainly in eastern Asia, mostly in adults but less frequently overall. The characteristics of this group of patients are as follows. Once the patient develops, the condition is very aggressive, with a severe degree of ketoacidosis, and he or she can fall into a coma very quickly, requiring immediate resuscitation.
- Emergency of onset
- Hyperglycemic state of ≤1 week duration with ketoacidosis
- Decreased serum C-peptide secretion
- First blood glucose >16 mmol/L (mmol/L) and HbAlc <8.5%