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非典型糖尿病研究进展
李妍1,2,崔文洁1,曲伸1,2*
0
(1. 同济大学附属第十人民医院内分泌科, 上海 200072;
2. 南京医科大学第一临床学院, 南京 211100
*通信作者)
摘要:
非典型糖尿病(ADM)是一类以高血糖、酮症或酸中毒等急性症状起病,但伴有胰岛素抵抗,而以胰岛素相关抗体阴性为特点的疾病,其短期内需胰岛素治疗,后可逐渐停用胰岛素改用口服药治疗或仅通过生活方式干预即可控制血糖。ADM被认为是不同于经典1型或2型糖尿病的一种新类型。本文围绕ADM的流行病学、临床特点、病理生理机制、诊断及治疗的最新进展进行综述,以提高临床医生对该病的认识,防止在临床工作中漏诊及误诊。
关键词:  非典型糖尿病  酮症倾向2型糖尿病  胰岛素分泌细胞  胰岛素抵抗
DOI:10.3724/SP.J.1008.2015.01112
投稿时间:2015-03-07修订日期:2015-07-27
基金项目:
Research progress on atypical diabetes mellitus
LI Yan1,2,CUI Wen-jie1,QU Shen1,2*
(1. Department of Endocrinology, The Tenth People's Hospital of Shanghai, Tongji University, Shanghai 200072, China;
2. The First Clinical College, Nanjing Medical University, Nanjing 211100, Jiangsu, China
*Corresponding author.)
Abstract:
Atypical diabetes mellitus (ADM) is characterized by severe hyperglycemia and unprovoked ketosis or ketoacidosis, with insulin resistance but with negative insulin-related antibody. The treatment of ADM firstly needs a short-term insulin therapy, which can be replaced by oral glycemic agent therapy or lifestyle intervention to control the blood glucose. ADM is regarded as a new subtype of diabetes different from typical type 1 diabetes mellitus and type 2 diabetes mellitus. In this paper, we reviewed the latest research progress on ADM, including its prevalence, clinical presentation, pathogenesis, diagnosis and management, hoping to help clinicians to better understand ADM and avoid the missed diagnosis and misdiagnosis.
Key words:  atypical diabetes mellitus  ketosis-prone type 2 diabetes  insulin-secreting cells  insulin resistance