开始使用胰岛素的时间不能用于定义成人隐匿性自身免疫性糖尿病。
Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults.
作者信息
Brophy Sinead, Yderstraede Knud, Mauricio Didac, Hunter Stephen, Hawa Mohammed, Pozzilli Paolo, Schernthaner Guntram, Schloot Nanette, Buzzetti Raffaella, Davies Helen, Leslie David, Williams Rhys
机构信息
School of Medicine, Swansea University, Swansea SA2 8PP, UK.
出版信息
Diabetes Care. 2008 Mar;31(3):439-41. doi: 10.2337/dc07-1308. Epub 2007 Dec 14.
OBJECTIVE
Latent autoimmune diabetes in adults is type 1 diabetes presenting as non-insulin dependent diabetes. One feature of the selection criteria is time independent of insulin treatment. We examine the validity of this criterion.
RESEARCH DESIGN AND METHODS
Patients were recruited in nine European centers, and clinicians reported on criteria for initiating insulin. All patients were tested for GAD antibodies (GADAs) in a central laboratory. We examined time to insulin treatment for GADA-positive patients in six participating centers.
RESULTS
There was intercenter variation in the criteria used to initiate insulin. Median time to insulin was 16.15 months (interqartile range 6.7-25.5) in centers with GADA testing compared with 45.6 months (29.5-61.8) in centers without routine GADA testing (P < 0.002).
CONCLUSION
Time to insulin should not be used to define patients with LADA because it is dependent on local clinical judgment and the use of laboratory tests for GADA.
目的
成人隐匿性自身免疫性糖尿病是表现为非胰岛素依赖型糖尿病的1型糖尿病。选择标准的一个特征是与胰岛素治疗无关的时间。我们检验了该标准的有效性。
研究设计与方法
在欧洲的九个中心招募患者，临床医生报告开始使用胰岛素的标准。所有患者均在中心实验室检测谷氨酸脱羧酶抗体（GADA）。我们在六个参与中心研究了GADA阳性患者开始胰岛素治疗的时间。
结果
各中心在开始使用胰岛素的标准方面存在差异。进行GADA检测的中心，开始使用胰岛素的中位时间为16.15个月（四分位间距6.7 - 25.5），而未进行常规GADA检测的中心为45.6个月（29.5 - 61.8）（P < 0.002）。
结论
开始使用胰岛素的时间不应被用于定义成人隐匿性自身免疫性糖尿病患者，因为这取决于当地的临床判断以及GADA实验室检测的使用情况。
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