暴发性1型糖尿病研究新进展

Research progress in fulminant type 1 diabetes

暴发性1型糖尿病(FT1DM)是一种T1DM亚型,以迅速进展的胰岛β细胞破坏、高血糖症状和DKA,并缺乏糖尿病相关抗体为特征,被归入1B型糖尿病,属于糖尿病的急危重症。FT1DM发病与人类白细胞抗原基因型有关,免疫及肠道病毒等参与发病,但发病机制尚不明确。FT1DM与T2DM有关,既往T2DM病史者不能排除FT1DM。孕期胰岛自身免疫可能参与并促进FT1DM的发展,孕妇是该病高发人群,胎儿预后极差。

Fulminant type 1 diabetes is a new subtype of type 1 diabetes.It is a syndrome characterized by a markedly rapid and almost complete destruction of pancreatic β-cells,severe hyperglycemia,DKA,and negative of diabetic related antibodies.Metabolic derangement is extremelysevere in this subtype,and it is also considered to be type 1 Bdiabetes.Several lines of evidence suggest that human leukocyte antigen,and environmental factors,such as viral infection,contribute to the development of this disease.The mechanism ofβ-cell death in fulminant type 1 diabetes should be further investigated.FT1DM is associated with T2DM,and we cannot exclude FT1DM even if the patient only has T2DM history.The autoimmunity of islet during pregnancy may be enrolled in the development of FT1DM,which puts pregnant women into high risk of FT1DM,and fetal poor prognosis.