成人隐匿性自身免疫糖尿病32例临床特征分析

目的观察分析成人隐匿性自身免疫糖尿病(LADA)患者的临床特征,提高其防治水平。方法将32例GAD-Ab阳性LADA患者作为研究对象,均测量身高、体重、腰臀比、血压,并测定空腹血糖、血脂、C肽、HbA1c和标准餐后2h血糖、C肽。结果 LADA患者发病年龄范围较广,胰岛素的分泌能力较T2DM差,存在胰岛素抵抗。部分患者体形肥胖,伴有高血压和(或)血脂异常。结论 LADA患者既存在胰岛素缺乏,又有胰岛素抵抗,LADA患者诊断后需要尽早使用胰岛素治疗,可联用胰岛素增敏剂治疗改善胰岛素抵抗。

Clinical characteristics of 32 patients with latent autoimmune diabetes

OBJECTIVE To analyze the clinical characteristics of 32 patients with latent autoimmune diabetes,and to improve its prevention and treatment measures.METHODS 32 patients with GAD-Ab positive were selected as investigating subjects.The height,weight,waist-hip ratio and blood pressure were measured,and fasting blood glucose,blood lipid,C-peptide,HbA1c and standard 2-hour postprandial blood glucose were tested in all subjects.RESULTS The age range of the LADAs was wider.Insulin secretion was poorer in patients with LADA compared with patients with T2DM.Patients with LADA had insulin resistance,and some were not only fat but also had high blood pressure and/or dyslipidemia.CONCLUSION The patients with LADA have been both insulin deficiency,and insulin resistance.They need early insulin treatment after diagnosed,and insulin sensitizing agents can be accompanied to improve insulin resistance.