The diagnostic criteria for slowly progressive type 1 diabetes (slowly progressive insulin-dependent diabetes mellitus; SPIDDM) have been revised by the Committee on Type 1 Diabetes of the Japan Diabetes Society. All of the following three criteria must be met for ‘a definitive diagnosis of SPIDDM’: (1) presence of anti-islet autoantibodies at some point in time during the disease course; (2) absence of ketosis or ketoacidosis at the diagnosis of diabetes with no requirement for insulin treatment to correct hyperglycemia immediately after diagnosis in principle; and (3) gradual decrease of insulin secretion over time, with insulin treatment required at more than 3 months after diagnosis, and the presence of severe endogenous insulin deficiency (fasting serum C-peptide immunoreactivity <0.6 ng/mL) at the last observed point in time. When a patient fulfills only (1) and (2), but not (3), he/she is diagnosed with ‘SPIDDM (probable)’ because the diabetes is non-insulin-dependent type.

中文翻译：

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慢进展1型糖尿病（SPIDDM）新诊断标准（2023年）：日本糖尿病学会1型糖尿病委员会报告（英文版）

日本糖尿病学会1型糖尿病委员会已修订缓慢进展型1型糖尿病（缓慢进展型胰岛素依赖型糖尿病；SPIDDM）的诊断标准。“SPIDDM 的明确诊断”必须满足以下三个标准： (1) 在病程的某个时间点存在抗胰岛自身抗体；（2）糖尿病诊断时无酮症或酮症酸中毒，诊断后原则上不需要立即进行胰岛素治疗纠正高血糖；(3)随着时间的推移，胰岛素分泌逐渐减少，诊断后3个月以上需要胰岛素治疗，并且在最后观察点存在严重的内源性胰岛素缺乏（空腹血清C肽免疫反应性<0.6 ng/mL）及时。当患者仅满足（1）和（2），但不满足（3）时，他/她被诊断为“SPIDDM（可能）”，因为糖尿病是非胰岛素依赖型。