Retrospective analysis about effects of initiating insulin therapy on islet function patients with latent autoimmune diabetes in adults
10.3760/cma.j.issn.1671-7368.2016.05.011
- VernacularTitle:起始应用胰岛素治疗对成人隐匿性自身免疫性糖尿病患者胰岛功能影响的回顾性分析
- Author:
Yan MA
;
Kai FENG
;
Wei LI
;
Fan PING
;
Dong ZHAO
;
Yuxiu LI
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,autoimmune,adults;
Insulin;
Antibodies,antiglutamate decarboxylase;
Diabetes complications
- From:
Chinese Journal of General Practitioners
2016;15(5):356-360
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of initiating oral-medication and insulin-treatment to residual islet function in adult patients with latent autoimmune diabetes in adults (LADA).Methods Fifty nice inpatients and 11 outpatients of LADA were enrolled from the Peking Union Medical College Hospital from January 1981 to October 2014,including 34 cases with initiating insulin therapy and 36 cases with initiating oral medication.Patients were followed up at least twice and with a 6-month interval.The age,body mass index (BMI),diagnosis time,fasting C peptide (FCP),2-hour postprandial C peptide (2 hCP),glycosylated hemoglobin (HbA1c) were compared between two groups.Results The age of disease onset in insulin-treatment group was significantly lower than that in oral-medication group (t =2.049,P =0.045).The proportion of patients complicated with other autoimmune diseases in oralmedication group were higher than that in insulin-treatment group [24％ (8/34) vs.47％ (17/36),x2=4.275,P=0.039].The FCP and 2 hCP in insulin-treatment group were significantly higher than those in oral-medication group [FCP:0.25 (0.00-0.80) vs.0.00 (0.00-0.60) μg/L,Z =3.498,P =0.030,2 hCP:0.42(0.02-1.20) vs.0.14(0.02-0.19) μg/L,Z =3.235,P=0.001] on 6 month after treatment;however,there were no significant differences on 6-12 months,13-36 months or 37-60 months after treatment between two groups.No antibody negative conversion was detected in 10 inpatients,who were reexamined with glutamic acid decarboxylase antibody (GADA) more than twice.The detection rate of diabetes retinopathy was 4％ (1/26) in insulin-treatment group and 28％ (8/29) in oralmedication group (x2 =6.179,P =0.013).Conclusion Initiating insulin therapy at first diagnosis of LADA can protect the residual islet function,and may reduce the rate of diabetic retinopathy.
