Diabetes Center Bad Lauterberg, Bad Lauterberg, Germany.
Diabetes, Endocrinology and Metabolism Section, Department of Medicine I, St. Josef-Hospital, Katholisches Klinikum Bochum gGmbH, Ruhr University of Bochum, Bochum, Germany.
Diabetes Metab J. 2023 Jan;47(1):140-146. doi: 10.4093/dmj.2021.0322. Epub 2022 Mar 22.
In clinical practice, the distinction between type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) can be challenging, leaving patients with "ambiguous" diabetes type. Insulin-treated patients (n=115) previously diagnosed with T2DM had to be re-classified based on clinical phenotype and laboratory results, and were operationally defined as having an ambiguous diabetes type. They were compared against patients with definite T1DM and T2DM regarding 12 clinical and laboratory features typically different between diabetes types. Characteristics of patients with ambiguous diabetes type, representing approximately 6% of all patients with T1DM or T2DM seen at our specialized clinic, fell in between those of patients with definite T1DM and T2DM, both regarding individual features and with respect to a novel classification based on multi-variable regression analysis (P<0.0001). In conclusion, a substantial proportion of diabetes patients in a tertiary care centre presented with an "ambiguous" diabetes type. Their clinical characteristics fall in between those of definite T1DM or T2DM patients.
在临床实践中,1 型糖尿病(T1DM)和 2 型糖尿病(T2DM)之间的区别具有挑战性,导致患者的糖尿病类型“不明确”。先前被诊断为 T2DM 的胰岛素治疗患者(n=115)必须根据临床表型和实验室结果重新分类,并被定义为具有不明确的糖尿病类型。将这些患者与明确的 T1DM 和 T2DM 患者进行比较,比较了 12 种通常在不同糖尿病类型之间存在差异的临床和实验室特征。不明确糖尿病类型患者的特征代表了在我们专门诊所就诊的所有 T1DM 或 T2DM 患者中约 6%,这些患者在个体特征以及基于多变量回归分析的新型分类方面,均处于明确的 T1DM 和 T2DM 患者之间(P<0.0001)。总之,在一家三级保健中心,相当一部分糖尿病患者表现出“不明确”的糖尿病类型。他们的临床特征介于明确的 T1DM 或 T2DM 患者之间。