[Advances in clinical laboratory tests for diabetes mellitus]

Advances in clinical laboratory tests for diabetes mellitus have been reported. 1) Examinations for diagnosis of diabetes mellitus: Assay of autoantibody to glutamic acid decarboxylase was commercially developed recently. This is useful for distinguishing insulin-dependent diabetes mellitus (IDDM) from non-autoimmune diabetes and for predicting the prognosis in IDDM. 2) Examinations for assessment of glycemic control: New methods of assessing glycemic control in patients with diabetes mellitus (glycated albumin, 1,5-anhydroglucitol) have been developed. It is important to be familiar with the characteristics of each test and to use each one properly. Because of the large interlaboratory difference in glycohemoglobin (GHb) measurement has been an issue of greatest importance, standardization of GHb measurement was required. To reduce this difference, it is recommended to remove unstable GHb and to correct the value using the JDS GHb standard. Currently, the difference has been reduced to a clinically permissible level (the fourth report of the GHb standardization committee). 3) Examinations for chronic complications in diabetes: Disturbances of the central nervous system may occur as diabetic neuropathy in patients with diabetes mellitus. Progress in thermology has revealed latent aortic occlusive disease in the legs and autonomic disturbance that lead to abnormal vascular responses. 4) Examinations for self-monitoring of blood glucose: The technology used for noninvasive blood glucose monitoring involves either radiation or fluid extraction. Each method has features predicting commercial viability.