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September 1, 1978

Diagnostic Criteria in Diabetes

JAMA. 1978;240(9):864-865. doi:10.1001/jama.1978.03290090058023

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Reflecting an impaired glucose tolerance, the abnormal glucose tolerance test has for long been considered the criterion for diagnosing diabetes. The test retained this exalted status even when an abnormal glucose tolerance was demonstrated in a variety of other disorders. These were simply dismissed as secondary diabetes. The test remained as the criterion even after familial studies, clinical observations, and plasma-insulin determinations disclosed that it did not differentiate between the juvenile insulin-dependent and the maturity-onset types of diabetes.

Elsewhere in this issue (p 833) Turkington and Weinding reject the abnormal glucose-tolerance test as a criterion for diagnosing diabetes. They discredit it primarily because in their series of 334 diabetic patients observed for a period of 18 years, the test failed to predict what is considered to be the hallmark of diabetes, its late complications, particularly diabetic retinopathy, which is specific to diabetes. The only predictor of these complications was insulin