成人特发性1型糖尿病首次强化降糖期间的临床特点  

作　　者：姜胜强 王璟 王晶晶 裘嘉琪 

机构地区：[1]浙江省嵊州市人民医院,浙江大学附属第一医院嵊州分院,312400

出　　处：《浙江临床医学》2021年第10期1460-1461,1465,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨特发性1型糖尿病患者首次强化控制血糖期间的临床特点。方法收集2007年5月至2019年9月初次诊治疑为特发性1型糖尿病的患者31例,经长期随访并记录期间的临床表现、血糖控制情况及胰岛功能演变。回顾性分析患者原始临床资料及随诊资料后明确诊断为特发性1型糖尿病。结果31例患者强化降糖治疗期间,其中21例反复发生无法解释的血糖波动,10例反复发生无法解释的低血糖初始的空腹、餐后2 hC肽水平与强化控糖治疗后比较,差异均无统计学意义(P>0.05)。随访7~53个月,复查空腹C肽和餐后2 hC肽水平均<0.01 ng/mL。结论发病早期出现空腹及餐后C肽水平明显低于参考值下限、胰岛自身抗体均阴性、首次强化控制血糖期间频繁发生无法解释的低血糖或无法解释的血糖波动等特征,均可高度疑诊特发性1型糖尿病。Objective To explore the clinical characteristics of patients with idiopathic type 1 diabetes during the first intensive blood glucose control.Methods There were 31 patients suspected to have idiopathic type 1 diabetes at the time of initial diagnosis from May 2007 to September 2019 were collected.After long-term follow-up and recording of clinical manifestations,blood sugar levels and islet function evolution during the followup period,the collected data were retrospectively analyzed and confirmed ns idiopathic type 1 diabetes.Results During the intensive hypoglycemic treatment of 31 patients,21 cases had repeated unexplained blood glucose fluctuations,and 10 cases had repeated unexplained hypoglycemia.There was no significant difference in C-peptide levels between the initial fasting and 2 hours postprandial and after the intensive glucose control treatment(P>0.05).The follow-up period was 7 to 53 months,and the fasting C-peptide and the C-peptide level of 2 hours after a meal were re-examined<0.01 ng/mL.Conclusion Early onset of idiopathic type 1 diabetes should be highly suspected in patients with the following characteristics:fasting and postprandial C-peptide levels are significantly lower than the lower limit of reference value,islet autoantihodies are negative,and unexplained hypoglycemia or unexplained fluctuations of blood glucose frequently occur during the first intensive blood glucose control.

关 键 词：特发性1型糖尿病 胰岛自身抗体 C肽 血糖波动 低血糖 高糖毒性 

分 类 号：R58[医药卫生—内分泌]