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Summary  The relationship between chemical diabetes and overt diabetes in 145 nonobese adult subjects has been examined. The degree of glucose intolerance, insulin response to oral glucose, and insulin resistance in normal subjects and patients with nonketotic diabetes were first determined. These variables were then analyzed by a computer program which permits direct visualization of the three-dimensional shape of the data set. The picture obtained was that of a boomerang with two wings and a fat middle. The patients were then divided into three groups (normal, chemical diabetes, overt diabetes) on the basis of their oral glucose tolerance. Two-dimensional views of the relationship between the metabolic variables in these subjects resembled the initial three-dimensional image, i. e., a central core with two wings going off in opposite directions. The two wings represented patients with chemical diabetes and overt diabetes, respectively. Following this, the patients were reclassified on the basis of all three metabolic variables (plasma glucose response to oral glucose, plasma insulin response to oral glucose, and degree of insulin resistance) by means of a computer classification which employed a cluster analysis technique. This again resulted in the definition of three groups, in which there was a divergence between subjects classified as having chemical diabetes as contrasted to overt diabetes. This apparent separation between subjects with chemical and overt diabetes may explain why patients with chemical diabetes rarely develop overt diabetes.

An attempt to define the nature of chemical diabetes using a multidimensional analysis