对暴发性1型糖尿病临床特征的探讨

Clinical Characteristics of Fulminant Type 1 Diabetes Mellitus

目的对2010年1月至2019年7月发表的暴发性1型糖尿病(FT1DM)个案共81篇116例患者临床特征进行分析和探讨。方法回顾性分析116例患者的临床资料,总结其临床特点。结果男女发病比例为1∶1.17,女性患者发病更早[(31.20±11.24)岁vs(36.93±15.24)岁],均于1周内出现DKA。部分患者伴有前驱感染症状、消化系统症状及三多一少症状。女性患者发病时血糖较低[(34.40±9.75)mmol/L vs(38.77±13.54)mmol/L],HbA1c水平4.6%~8.6%,且女性患者空腹C肽水平更低[(0.03±0.06)mmol/L vs(0.06±0.09)ng/mL],胰岛功能几乎完全丧失。少部分患者T1DM自身抗体阳性。多数患者使用胰岛素强化替代治疗。结论FT1DM病情危重,进展迅速,需长期使用外源性胰岛素替代治疗,应引起高度重视。

Objective To analyse and explore clinical characteristics of 116 patients with fulminant type 1 diabetes mellitus(FT1DM)published from January 2010 to July 2019.Methods The chinical data of 116 patients were analyzed retrospectively,and the clinical features were summarized.Results The incidence ratio of male to female was 1:1.17,and women get sick earlier[(31.20±11.24)vs.(36.93±15.24)years old].All patients presented with ketoacidosis within one week.Some patients had prodromal infection symptoms,digestive system symptoms or diabetes symptoms.Women suffer from lower blood sugar levels than men[(34.40±9.75)vs.(38.77±13.54)mmol/L].The range of HbA1c level was 4.6%-8.6%.Women suffer from lower fasting c-peptide levels than men[(0.03±0.06)vs.(0.06±0.09)ng/mL].Pancreatic beta cells were rapidly destroyed.Some patients’T1DM autoantibody were positive.Most patients need long-term insulin replacement therapy.Conclusion FT1DM has remarkably abrupt onset and lifelong injection of exogenous insulin is inevitable.Physicians should sharpen their awareness of FT1DM.