[Diagnosis and treatment of diabetes mellitus-recent advances]

In 1982, two years after the second report of the WHO Expert Committee on Diabetes Mellitus, new diagnostic criteria for diabetes mellitus were recommended by the Japan Diabetes Society and widely used in Japan. In the assessment of diabetic control, a blood ketone body measurement kit was developed and has been used for detecting its metabolic abnormality. Glycated hemoglobin has been introduced to clinical practice as an index of the past 1-2 months' diabetic control, fructosamine of the past 1-2 weeks' diabetic control and they are effectively used to achieve the good metabolic control. In the field of treatment, the extrapancreatic action of the sulfonylurea agent has been re-estimated and combination therapy with insulin is now being tested. In insulin treatment, conventional insulin injection (once a day) was not sufficient for preventing the chronic vascular complication of diabetes and intensive insulin therapy has been strongly recommended and is gradually coming into wide use. Since the development of an insulin injection pump, we have been able to mimic the normal insulin secretion pattern. With the increase of blood glucose self-monitoring, the sliding scale method can be used where the patient himself adjusts the insulin dose under certain circumstances.