Kobayashi Michi, Ohara Nobumasa, Ikeda Yohei, Nagano Ouki, Takada Toshinori, Kodama Makoto, Sone Hirohito
Department of Endocrinology and Metabolism, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan.
Department of Radiology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan.
Intern Med. 2018 Dec 15;57(24):3581-3587. doi: 10.2169/internalmedicine.1008-18. Epub 2018 Aug 10.
A 59-year-old non-obese Japanese woman developed diabetes mellitus with a negative glutamic acid decarboxylase autoantibody (GADA) test result. Her hyperglycemia was initially well controlled by oral hypoglycemic agents; however, despite continued treatment the hyperglycemia gradually worsened. As she had endogenous insulin deficiency and tested positive for insulin autoantibody (IAA), insulin therapy was initiated. Few studies have investigated GADA-negative patients with slowly progressive type 1 diabetes mellitus (SPT1D). Our IAA-positive SPT1D patient progressed from the clinical onset of diabetes mellitus to starting insulin therapy relatively quickly (1.5 years), similarly to other previously reported non-obese patients with GADA-positive SPT1D.
一名59岁非肥胖日本女性患糖尿病,谷氨酸脱羧酶自身抗体(GADA)检测结果为阴性。她的高血糖最初通过口服降糖药得到良好控制;然而,尽管持续治疗,高血糖仍逐渐恶化。由于她存在内源性胰岛素缺乏且胰岛素自身抗体(IAA)检测呈阳性,遂开始胰岛素治疗。很少有研究调查GADA阴性的缓慢进展型1型糖尿病(SPT1D)患者。我们这位IAA阳性的SPT1D患者从糖尿病临床发病到开始胰岛素治疗的进展相对较快(1.5年),与之前报道的其他GADA阳性的非肥胖SPT1D患者类似。