Simsek S, Diamant M, Eekhoffen E M W, Heine R J
VU Medisch Centrum, afd. Endocrinologie/Diabetescentrum, Postbus 7057, I007 MB Amsterdam.
Ned Tijdschr Geneeskd. 2006 May 6;150(18):1007-12.
The classification of diabetes mellitus is not always straightforward but is of clinical importance in view of the differences in treatment, prognosis and inheritance. In young patients with acute signs ofhyperglycaemia and a low bodymass index (BMI), diabetes type 1 is the evident diagnosis, and insulin therapy should be initiated as quickly as possible. Deafness in patients with mild symptoms and a highly positive family history suggests the presence of a mitochondrial or maternally inherited type of diabetes: maternally inherited diabetes and deafness (MIDD). In the absence of deafness, maturity onset diabetes of the young (MODY) should be suspected in the same group of patients. In case of a non-acute presentation of hyperglycaemia without an evident family history of diabetes, the BMI can be helpful in the next steps of the diagnostic process. In practice, the proposed flow chart can readily be applied for the classification and treatment of patients with hyperglycaemia.
糖尿病的分类并非总是一目了然，但鉴于治疗、预后和遗传方面的差异，其具有临床重要性。对于有急性高血糖体征且体重指数（BMI）较低的年轻患者，1型糖尿病是明确的诊断，应尽快开始胰岛素治疗。症状轻微且家族史呈强阳性的患者出现耳聋提示存在线粒体或母系遗传型糖尿病：母系遗传糖尿病伴耳聋（MIDD）。在没有耳聋的情况下，同一组患者应怀疑为青年发病的成年型糖尿病（MODY）。对于无明显糖尿病家族史的非急性高血糖表现，BMI在诊断过程的后续步骤中可能会有所帮助。在实践中，所提出的流程图可很容易地应用于高血糖患者的分类和治疗。
