Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)

Abstract Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non‐insulin‐dependent state; therefore, a more flexible treatment ca...

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Main Authors: Akira Shimada, Eiji Kawasaki, Norio Abiru, Takuya Awata, Yoichi Oikawa, Haruhiko Osawa, Hiroshi Kajio, Junji Kozawa, Kazuma Takahashi, Daisuke Chujo, Shinsuke Noso, Tomoyasu Fukui, Junnosuke Miura, Kazuki Yasuda, Hisafumi Yasuda, Akihisa Imagawa, Hiroshi Ikegami
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Diabetes Investigation
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Online Access:https://doi.org/10.1111/jdi.14267
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author Akira Shimada
Eiji Kawasaki
Norio Abiru
Takuya Awata
Yoichi Oikawa
Haruhiko Osawa
Hiroshi Kajio
Junji Kozawa
Kazuma Takahashi
Daisuke Chujo
Shinsuke Noso
Tomoyasu Fukui
Junnosuke Miura
Kazuki Yasuda
Hisafumi Yasuda
Akihisa Imagawa
Hiroshi Ikegami
author_facet Akira Shimada
Eiji Kawasaki
Norio Abiru
Takuya Awata
Yoichi Oikawa
Haruhiko Osawa
Hiroshi Kajio
Junji Kozawa
Kazuma Takahashi
Daisuke Chujo
Shinsuke Noso
Tomoyasu Fukui
Junnosuke Miura
Kazuki Yasuda
Hisafumi Yasuda
Akihisa Imagawa
Hiroshi Ikegami
author_sort Akira Shimada
collection DOAJ
description Abstract Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non‐insulin‐dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase‐4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin‐dependent state.
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publishDate 2025-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Investigation
spelling doaj-art-ae4e6bbe94f84e25ae0ae7ebb9f5218a2025-08-20T02:44:02ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-01-0116116316810.1111/jdi.14267Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)Akira Shimada0Eiji Kawasaki1Norio Abiru2Takuya Awata3Yoichi Oikawa4Haruhiko Osawa5Hiroshi Kajio6Junji Kozawa7Kazuma Takahashi8Daisuke Chujo9Shinsuke Noso10Tomoyasu Fukui11Junnosuke Miura12Kazuki Yasuda13Hisafumi Yasuda14Akihisa Imagawa15Hiroshi Ikegami16Department of Endocrinology and Diabetes Saitama Medical University Saitama JapanDiabetes Center Shin‐Koga Hospital Fukuoka JapanMidori Clinic Nagasaki JapanDiabetes Research Center National Center for Global Health and Medicine Tokyo JapanDepartment of Endocrinology and Diabetes Saitama Medical University Saitama JapanDepartment of Diabetology Ehime University Graduate School of Medicine Toon Ehime JapanDepartment of Diabetes, Endocrinology and Metabolism National Center for Global Health and Medicine Hospital Tokyo JapanEndowed Department of Diabetes Medicine Osaka University Graduate School of Medicine Osaka JapanSchool of Nursing Iwate Prefectural University Takizawa Iwate JapanCenter for Clinical Research Toyama University Hospital Toyama JapanDepartment of Endocrinology, Metabolism and Diabetes Kindai University Faculty of Medicine Osaka JapanDivision of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine Showa University Tokyo JapanDivision of Diabetes and Metabolism, Department of Internal Medicine Tokyo Women's Medical University School of Medicine Tokyo JapanDepartment of Diabetes, Endocrinology and Metabolism Kyorin University School of Medicine Tokyo JapanDivision of Health Sciences, Department of Public Health Kobe University Graduate School of Health Sciences Kobe Hyogo JapanDepartment of Internal Medicine (I), Faculty of Medicine Osaka Medical and Pharmaceutical University Takatsuki Osaka JapanDepartment of Endocrinology, Metabolism and Diabetes Kindai University Faculty of Medicine Osaka JapanAbstract Insulin treatment should be introduced in patients with slowly progressive type 1 diabetes (SPIDDM; definite), according to the revised diagnostic criteria of SPIDDM (2023). In contrast, SPIDDM (probable) patients are in a non‐insulin‐dependent state; therefore, a more flexible treatment can be considered, although sulfonylurea agents should be avoided. Insulin treatment has been shown to maintain endogenous insulin secretion capacity in SPIDDM (probable); however, this does not mean that all SPIDDM (probable) patients should use insulin from the early phase. Dipeptidyl peptidase‐4 inhibitors and biguanides might be the treatment of choice for SPIDDM (probable), but no evidence exists for other hypoglycemic agents. In any case, careful monitoring of the endogenous insulin secretion capacity should be carried out, and if a decrease in insulin secretion capacity is suspected, a change in treatment should be considered to prevent progression to an insulin‐dependent state.https://doi.org/10.1111/jdi.14267Hypoglycemic drugsInsulin‐independent stateSlowly progressive insulin‐dependent diabetes
spellingShingle Akira Shimada
Eiji Kawasaki
Norio Abiru
Takuya Awata
Yoichi Oikawa
Haruhiko Osawa
Hiroshi Kajio
Junji Kozawa
Kazuma Takahashi
Daisuke Chujo
Shinsuke Noso
Tomoyasu Fukui
Junnosuke Miura
Kazuki Yasuda
Hisafumi Yasuda
Akihisa Imagawa
Hiroshi Ikegami
Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
Journal of Diabetes Investigation
Hypoglycemic drugs
Insulin‐independent state
Slowly progressive insulin‐dependent diabetes
title Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
title_full Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
title_fullStr Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
title_full_unstemmed Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
title_short Practice guideline: Statement regarding treatment for suspected slowly progressive type 1 diabetes (SPIDDM; probable) cases (English version)
title_sort practice guideline statement regarding treatment for suspected slowly progressive type 1 diabetes spiddm probable cases english version
topic Hypoglycemic drugs
Insulin‐independent state
Slowly progressive insulin‐dependent diabetes
url https://doi.org/10.1111/jdi.14267
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