非典型糖尿病研究进展

Research progress on atypical diabetes mellitus

非典型糖尿病(ADM)是一类以高血糖、酮症或酸中毒等急性症状起病,但伴有胰岛素抵抗,而以胰岛素相关抗体阴性为特点的疾病,其短期内需胰岛素治疗,后可逐渐停用胰岛素改用口服药治疗或仅通过生活方式干预即可控制血糖。ADM被认为是不同于经典1型或2型糖尿病的一种新类型。本文围绕ADM的流行病学、临床特点、病理生理机制、诊断及治疗的最新进展进行综述,以提高临床医生对该病的认识,防止在临床工作中漏诊及误诊。

Atypical diabetes mellitus（ADM）is characterized by severe hyperglycemia and unprovoked ketosis or ketoacidosis,with insulin resistance but with negative insulin-related antibody.The treatment of ADM firstly needs a shortterm insulin therapy,which can be replaced by oral glycemic agent therapy or lifestyle intervention to control the blood glucose.ADM is regarded as a new subtype of diabetes different from typical type 1diabetes mellitus and type 2diabetes mellitus.In this paper,we reviewed the latest research progress on ADM,including its prevalence,clinical presentation,pathogenesis,diagnosis and management,hoping to help clinicians to better understand ADM and avoid the missed diagnosis and misdiagnosis.