The Pharmaceutical Journal
Vol 275 No 7367 p330
17 September 2005

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Diabetes classifications blurred and need updating

Distinctions between juvenile type 1 and type 2 diabetes are being blurred and their classifications need to be re-explored, Dorothy Becker of the Children's Hospital of Pittsburgh told a symposium at the European Association for the Study of Diabetes in Athens this week.

By convention, Dr Becker explained, type 1 and type 2 diabetes are distinguished by the presence of islet cell autoantibodies, in type 1 diabetes, or their absence, in type 2. However, most children and adolescents with type 2 diabetes now have some evidence of islet cell autoimmunity. She suggests that juvenile diabetes should be classified as insulin-deficient diabetes, insulin-resistant diabetes or insulindeficient plus insulin-resistant diabetes. Dr Becker favours the name “double diabetes” for this last classification, but argues that therapy should be tailored to the needs of each patient, rather than to a name.