Häger A
Acta Paediatr Scand Suppl. 1977(270):103-5. doi: 10.1111/j.1651-2227.1977.tb15129.x.
An account is given of the present conception of asymptomatic (chemical) diabetes in the pediatric age group, which also has been named MODY (maturity-onset type of diabetes of young people). Long-term studies show that about 10% will eventually decompensate to overt diabetes. In contrast to classical juvenile-onset type of diabetes the inheritance of MODY seems to be autosomal dominant in many cases. Some authors have suggested that insulin resistance exists in non-obese patients with asymptomatic diabetes, but this view is not supported by observations of the author. Obese patients should reduce their body fat, but other therapeutic approaches are difficult to evaluate because of the normal fluctuation of the disease. There is no general agreement in the literature concerning the value of insulin treatment. The author supports the view that insulin treatment should be started in the late stages of chemical diabetes just before symptomatic disease emerges. In the long run this approach may ameliorate the condition due to the preservation of some beta-cell function for long periods. An unsettled question is whether early insulin treatment in asymptomatic diabetes will delay diabetic vascular complications.
本文阐述了小儿年龄组无症状（化学性）糖尿病的当前概念，该类型糖尿病也被称为MODY（青年成熟期糖尿病）。长期研究表明，约10%的患者最终会发展为显性糖尿病。与经典的青少年发病型糖尿病不同，MODY在许多情况下的遗传似乎是常染色体显性遗传。一些作者认为，无症状糖尿病的非肥胖患者存在胰岛素抵抗，但作者的观察结果并不支持这一观点。肥胖患者应减少体脂，但由于疾病的正常波动，其他治疗方法难以评估。关于胰岛素治疗的价值，文献中尚无普遍共识。作者支持这样的观点，即胰岛素治疗应在化学性糖尿病的晚期、症状性疾病出现之前开始。从长远来看，这种方法可能会改善病情，因为它能长时间保留一些β细胞功能。一个尚未解决的问题是，无症状糖尿病的早期胰岛素治疗是否会延迟糖尿病血管并发症的发生。
