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Comparison of the New Diagnostic Criteria for Diabetes Mellitus Recommended by the Expert Committee of the American Diabetes Association with the Criteria by the NDDG or WHO in Koreans with Fasting Plasma Glucose between 110 and 139 mg/dL

Other Title
공복혈당 110∼139mg/dL를 대상으로 당뇨병 진단에 관한 새로운 권고기준과 NDDG/WHO 진단기준의 비교
Authors
김, 여주; 남, 문석; 김, 미림; 김, 용성; 이, 관우; 김, 현만; 정, 춘희; 남, 수연; 차, 봉수; 김, 경래; 이, 현철; 권, 삼; 조, 용욱; 허, 갑범
Citation
The journal of Korean diabetes association, 22(2):209-217, 1998
Journal Title
The journal of Korean diabetes association; 당뇨병
ISSN
1015-6461
Abstract
Background: The current diagnostic criteria for diabetes mellitus announced by National

Diabetes Data Group(NDDG) in 1979 were revised by Expert Committee of World

Health Organization(WHO) in both 1980 and 1985. However, according to advancement

in the knowledge of the etiology and pathogenesis of diabetes mellitus, the 'International Expert Committee' working under the sponsorship of the American Diabetes Association(ADA) decided to adopt the resolution proposing that the criteria of fasting glucose level applied to diagnosis of diabetes mellitus should be lowered at the 57th ADA conference held in Boston, USA in June 1997('97 ADA).

Hereupon, by comparing the diagnostic criteria of the former(NDDG/WHO) with the

later, the authors have examined the usefulness of new diagnostic criteria, '97 ADA.

Method: We collected the data from 13 university hospitals in Korea which contain the results of 75 gram oral glucose tolerance test(OGTT) for 532 Koreans between 110 and 139 mg/dL in fasting plasma glucose. We have then evaluated the results by classifying and comparing them in accordance with the criteria of NDDG/WHO and '97 ADA,

respectively.

Results:

1. The number which tested for oral glucose tolerance was 532 and the majority of

tests have been carried out between 110 and 119 mg/dL in fasting plasma glucose.

2. When we have classified the same results of OGTT by respective diagnostic criteria

of NDDG/WHO and '97 ADA, the NDDG/WHO have diagnosed 50.4% (268/532) of the total number of people as diabetes mellitus, while the '97 ADA has shown that only

33.1%(176/532) of it corresponded to the same diagnosis. On the other hand, the

diagnosis rate of impaired fasting glucose(IFG) or impaired glucose tolerance(IGT) has

shown 28.8∼31.8%(NDDG/WHO) and 66.9%('97 ADA), respectively.

3. Following the diagnostic criteria of the '97 ADA, we have separated the results into two groups which were above and below 126 mg/dL in fasting glucose. In addition,

when we have again classified two groups by the criteria of the NDDG/WHO, the

group above 126mg/dL in fasting glucose, which was all diagnosed as diabetes mellitus

in '97 ADA has represented a ratio of 72.2%(127/176) in same diagnosis. However,

within the group below 126mg/dL in fasting glucose being classified as IFG in the '97

ADA, its diagnosis rate of diabetes mellitus has also shown 39.7% (141/356) applying to

the criteria of the NDDG/WHO.

Conclusion: The criteria of the '97 ADA can simply make a diagnosis of diabetes

mellitus with fasting plasma glucose and additionally find out the IFG whose rate is

17.9∼20% regarded as a normal condition by NDDG/WHO, whereas the existing criteria

of the NDDG/WHO have to carry out the OGTT which is difficult in clinics. However,

since among the patients of 50.4% diagnosed as diabetes mellitus by NDDG/WHO, the

'97 ADA classifies 17.3% of them as IFG, it is regarded that the need of OGTT for the

diagnosis of diabetes mellitus can not be passed over in the future.
Keywords
New Diagnostic CriteriaFasting Plasma GlucoseDiabetes Mellitus
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Endocrinology & Metabolism
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