Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus

• ACOG, American College of Obstetricians and Gynecologists
• FPG, fasting plasma glucose
• GCT, glucose challenge test
• GDM, gestational diabetes mellitus
• HNF, hepatocyte nuclear factor, IFG, impaired fasting glucose
• IGT, impaired glucose tolerance
• MODY, maturity-onset diabetes of the young
• NDDG, National Diabetes Data Group
• NHANES III, Third National Health and Nutrition Examination Survey
• OGTT, oral glucose tolerance test
• PAI-1, plasminogen activator inhibitor-1
• WHO, World Health Organization
• 2-h PG, 2-h postload glucose

The current classification and diagnosis of diabetes used in the U.S. was developed by the National Diabetes Data Group (NDDG) and published in 1979 (1). The impetus for the classification and diagnosis scheme proposed then holds true today. That is, the growth of knowledge regarding the etiology and pathogenesis of diabetes has led many individuals and groups in the diabetes community to express the need for a revision of the nomenclature, diagnostic criteria, and classification of diabetes. As a consequence, it was deemed essential to develop an appropriate, uniform terminology and a functional, working classification of diabetes that reflects the current knowledge about the disease. (1) It is now considered to be particularly important to move away from a system that appears to base the classification of the disease, in large part, on the type of pharmacological treatment used in its management toward a system based on disease etiology where possible.

An international Expert Committee, working under the sponsorship of the American Diabetes Association, was established in May 1995 to review the scientific literature since 1979 and to decide if changes to the classification and diagnosis of diabetes were warranted. The Committee met on multiple occasions and widely circulated a draft report of their findings and preliminary recommendations to the international diabetes community. Based on the numerous comments and suggestions received, including the opportunity to review unpublished data in detail, the Committee discussed and revised numerous drafts of a manuscript that culminated in this published document.

This report is divided into four sections: definition and description of diabetes, classification of the disease, diagnostic criteria, and testing for diabetes. The aim of this document is to define and describe diabetes as we know it today, present a classification scheme that reflects its etiology and/or pathogenesis, provide guidelines for the diagnosis …