Larger Étienne, Diedisheim Marc, Donath Xavier, Dehghani Léa, Sola-Gazagnes Agnès
Service de diabétologie et département universitaire, hôpital Cochin, Hôpitaux universitaires de Paris-Centre, Assistance publique-Hôpitaux de Paris, université de Paris René- Descartes, Paris, France, Inserm U1016, institut Cochin, Paris, France.
Rev Prat. 2018 Jun;68(6):614-618.
Diagnostic circumstances and clinical forms of type 1 diabetes. In its classic form, type 1 diabetes is the prototype of insulindependent diabetes. But ketoacidosis can occur outside of type 1 diabetes, so ketoacdosis does not necessarily mean definitive insulin therapy. Conversely, type 1 diabetes may initially be mistaken for type 2 diabetes. This is often associated with insulin delay after months of wandering and poor blood glucose control. New forms of diabetes have appeared, such as fulminant diabetes, specific to individuals from South Asia and the Far East, but also iatrogenic forms associated with new immunomodulatory treatments that revolutionize the management of certain cancers. This review presents the clinic and differential diagnosis of type 1 diabetes including these new forms of diabetes.
1型糖尿病的诊断情况及临床类型。经典形式的1型糖尿病是胰岛素依赖型糖尿病的原型。但酮症酸中毒也可能发生在1型糖尿病之外,所以酮症酸中毒并不一定意味着必须进行胰岛素治疗。相反,1型糖尿病最初可能会被误诊为2型糖尿病。这通常与数月血糖波动及血糖控制不佳后出现的胰岛素延迟有关。新的糖尿病形式已经出现,比如暴发性糖尿病,多见于南亚和远东地区的个体,还有与新型免疫调节治疗相关的医源性糖尿病形式,这些新型免疫调节治疗彻底改变了某些癌症的治疗方式。本综述介绍了1型糖尿病的临床情况及鉴别诊断,包括这些新的糖尿病形式。