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常规谷氨酸脱羧酶自身抗体(GADA)检测:患者视角

Routine glutamic acid decarboxylase autoantibody (GADA) testing: patients' perspective.

作者信息

Davies H, Mannan Sb, Brophy S, Williams R

机构信息

Centre for Health Information, Research and Evaluation (CHIRAL), The School of Medicine, Swansea University, The Grove Building, Singleton Park, Swansea SA2 8PP, UK.

出版信息

Fam Pract. 2008 Jun;25(3):176-80. doi: 10.1093/fampra/cmn016. Epub 2008 Apr 28.

Abstract

BACKGROUND

Latent autoimmune diabetes in adults (LADA) is a form of type 1 diabetes which in the UK is often diagnosed and treated as type 2 diabetes (T2D). People with LADA show slow progression to insulin dependence and can be distinguished from T2D by blood tests for glutamic acid decarboxylase autoantibodies (GADA). Aims. This study explores the views and experiences of patients who are newly diagnosed with LADA, with particular reference to (i) routine GADA testing; (ii) whether this diagnosis has any influence on the self-management of their diabetes; and (iii) the information needs of patients newly diagnosed with LADA.

METHODS

Ten consecutive patients newly diagnosed with LADA (GADA positive) were invited to participate in individual qualitative semi-structured interviews. Their views and experiences were analysed into codes and categories, using a constant comparative method.

FINDINGS

Participants supported routine GADA testing in all patients with diabetes because the provision of a correct diagnosis has an empowering effect on patients, as it encourages the consideration of treatment options early on in the condition. Participants preferred to rely on future Hba(1c) levels and their doctor's opinion to determine a change in treatment to insulin. Some participants had difficulty distinguishing between the different types of diabetes, including LADA. Others needed to ask questions about LADA in addition to written information.

CONCLUSIONS

Participants were supportive of routine GADA testing, would prefer not to start insulin immediately following a diagnosis of LADA and needed to discuss treatment options with health professionals who were knowledgeable on LADA.

摘要

背景

成人隐匿性自身免疫性糖尿病(LADA)是1型糖尿病的一种形式,在英国通常被诊断为2型糖尿病(T2D)并进行治疗。LADA患者向胰岛素依赖的进展缓慢,可通过检测谷氨酸脱羧酶自身抗体(GADA)与T2D相鉴别。目的。本研究探讨新诊断为LADA的患者的观点和经历,特别涉及(i)常规GADA检测;(ii)该诊断是否对其糖尿病自我管理有任何影响;以及(iii)新诊断为LADA的患者的信息需求。

方法

邀请连续10例新诊断为LADA(GADA阳性)的患者参加个人定性半结构式访谈。采用持续比较法将他们的观点和经历分析为代码和类别。

结果

参与者支持对所有糖尿病患者进行常规GADA检测,因为提供正确的诊断对患者有增强信心的作用,因为它鼓励在疾病早期就考虑治疗方案。参与者更愿意依靠未来的糖化血红蛋白(HbA1c)水平和医生的意见来确定是否改变为胰岛素治疗。一些参与者难以区分不同类型的糖尿病,包括LADA。其他人除了书面信息外,还需要询问有关LADA的问题。

结论

参与者支持常规GADA检测,在诊断为LADA后不愿立即开始使用胰岛素,需要与熟悉LADA的健康专业人员讨论治疗方案。

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