Definition, classification and diagnostics of diabetes mellitus

Abstract

This recommendation aims to provide up-todate information and the latest consensus on diabetes diagnosis from a group of experts in Germany. The disease diabetes mellitus is classified and its different types are described briefly. Options for diagnosis are presented including current cut-off values as well as reference intervals to recognize glucose utilization disorders like impaired fasting glucose or impaired glucose tolerance. Special attention is paid to the measurement value imprecision. The minimal difference (MD) is introduced as an excellent measure to distinguish measurement results which are analytically different from each other. Potential caveats considering pre-analytics in glucose measurement and limitations of HbA 1c assessment for diagnosis of diabetes mellitus are presented. Taken together, this recommendation provides a comprehensive overview of the state of the art in diabetes mellitus diagnosis and also critically evaluates potential pitfalls.