新发暴发性1型糖尿病与经典1型糖尿病及成人隐匿性自身免疫性糖尿病的临床特征比较  

Clinical comparison of newly onset fulminant type 1 diabetes mellitus,classical type 1 diabetes mellitus and LADA

作　　者：谢新荣[1] 钟慕贤 黄普好 XIE Xinrong;ZHONG Muxian;HUANG Puhao(Department of Endocrinology and Metabolism,Minzu Hospital of Guangxi Zhuangzu Autonomous Region,Nanning 530001,China)

机构地区：[1]广西壮族自治区民族医院内分泌代谢科,南宁530001

出　　处：《中国糖尿病杂志》2021年第10期754-757,共4页Chinese Journal of Diabetes

摘　　要：目的比较新发的暴发性1型糖尿病(FT1DM)与新发的经典T1DM及LADA不同的临床特征及生化指标特点,探讨FT1DM的特征及诊断鉴别区。方法选取2016年1月至2020年5月于我院内分泌代谢科住院的新发12例FT1DM患者(FT1DM组)、18例经典T1DM患者(T1DM组)及10例LADA患者(LADA组),比较其年龄、血糖、血钠、血钾、HbA1c、FC-P、2 hC-P、血pH、GADAb、IAA及Ins用量等指标。结果FT1DM组首诊血糖、SUA、血钾、Ins用量高于T1DM、LADA组(P<0.05);FT1DM组HbA1c、HCO_(3)^(-)、FC-P、2 h C-P及血pH低于T1DM、LADA组(P<0.05),GADAb低于LADA组(P<0.05);FT1DM组发病年龄高于T1DM组,低于LADA组(P<0.05)。结论新发FT1DM患者起病时具有更高的首诊血糖和血钾,HCO_(3)^(-)及p H值更低,酸中毒及胰岛β细胞破坏更严重,Ins用量更大。Objective To investigate the clinical characteristics and laboratory indicators of the newly-onset fulminant type 1 diabetes mellitus(FT1DM),classical type 1 diabetes mellitus(T1DM)and adult autoimmune type 1 diabetes mellitus(LADA)to help improve clinicians’understanding of FT1DM.Methods A total of 40 cases of newly onset T1DM including FT1DM,classic T1DM and LADA hospitalized in Endocrinology and Metabolism Department from January 2016 to May 2020 were selected.Age,blood glucose,blood sodium and potassium,hemoglobin A1 c,fasting and 2-hour C-peptide and blood p H were compared among the three groups.Results The initial blood glucose,serum urine acid,serum potassium,dosage of insulin in FT1DM group was higher than classical T1DM group and LADA group(P<0.05).The hemoglobin A1c,HCO_(3)^(-),fasting and 2-hour C-peptide,and blood p H was lower than classical T1DM group and LADA group(P<0.05).The onset age in FT1DM group was older than classical T1 DM group,but younger than LADA group.Conclusion Newly-onset FT1DM patients had higher initial blood glucose and potassium,lower p H,more severe acidosis,more severe damage to islet cells and larger dosage of insulin.

关 键 词：糖尿病 1型 暴发性 经典1型糖尿病 成人隐匿性自身免疫性糖尿病 酮症酸中毒 

分 类 号：R587.1[医药卫生—内分泌]