成人隐匿性自身免疫性糖尿病的临床特点和诊断要点

Clinical characters and main diagnostic points of late onset autoimmune diabetes mellitus in adults

目的 探讨 LADA的临床及诊断要点。方法 观察 LADA、成人 1型 DM、重症 2型 DM的临床、血糖、C肽水平、GADAb、ICA等。结果 LADA组自发性酮症 10例 ,GADAb阳性率 10 0 % ,高于 ICA。结论 LADA的诊断依据主要是 : 成人以 2型 DM起病方式发病和治疗 ,β细胞功能逐渐衰退 ,最终需胰岛素治疗 ; GADAb、ICA阳性。

Objective To probe into characters of the clinical and diagnostic points of patients with LADA. Methods Observing parameters as symptomatology, plasma glucose, C peptide, GADAb, ICA etc in patients with LADA, with adult onset type 1 diabetes and with serious type 2 diabetes. Results Development of autogenous ketosis in 10 cases in LADA. The positive rate of antibodies to GAD was 100% and higher than ICA. Conclusion We believe that diagnostic evidence of LADA were that ① diabetes occured in adult and were treated as type 2 diabetes, and the function of β cell decreased gradually with duration of disease and finally insulin therapy is necessary; and ②antibodies of GAD and ICA are positive.