Q. A 48-year-old male presents to the emergency department with a complaint of frequent urination, thirst, and fatigue for the past few months. He has no significant past medical history and is not taking any medications. The patient is admitted for further evaluation. Laboratory tests reveal a fasting blood glucose level of 270 mg/dL and an HbA1c level of 8.5 percent. Further investigation reveals the presence of autoantibodies to islet beta cells in the patient’s blood. His C-peptide level is also slightly reduced, indicating a moderate degree of insulin deficiency. You determine the absence of severe hyperglycemia and absence of classic symptoms of insulinopenic type 1 diabetes rule out a diagnosis of type 1 diabetes. During his hospital stay, you start him on insulin therapy to help control his blood glucose levels. His insulin requirements were relatively low, indicating a slow and progressive nature of the autoimmune destruction of his beta cells. He also undergoes additional testing to assess for the presence of other autoimmune conditions, such as thyroid disease, which was also negative. Which of the following criteria is NOT required to confirm the most likely diagnosis?