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October 26, 1984

Endocrinology and Metabolism

JAMA. 1984;252(16):2172-2176. doi:10.1001/jama.1984.03350160040014

For many years, "juvenile-onset" and "maturity-onset" diabetes mellitus were useful descriptive terms with both prognostic and therapeutic implications. Those diabetics in whom the disease begins in childhood or early adult life are generally ketosis prone and insulin requiring. Moreover, the onset of their disorder often appears to be explosive. Diabetes in older adults is gradual in its onset, often occurring in association with obesity. Many of these latter patients do not require insulin and their condition can be regulated by diet, with or without oral antidiabetic drugs. Some require insulin, but their treatment is usually easier than that of the juveniles, and they are not ketosis prone. Several years ago, diabeticians tried to replace these descriptive terms with "insulin dependent" (for juvenile onset) and "non-insulin dependent" (for maturity onset). More recently, the confusion created by these terms has been handled by the use of "type I" for insulin dependent and