Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults
Time to insulin initiation cannot be used in defining latent autoimmune diabetes in adults
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DOI：
10.2337/dc07-1308
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发表时间：
2008-03-01
期刊：
影响因子：
16.2
通讯作者：
Williams, Rhys
中科院分区：
文献类型：
--
作者：
Brophy, Sinead;Yderstrede, Knud;Williams, Rhys
目的：成人潜伏性自身免疫性糖尿病是表现为非胰岛素依赖型糖尿病的I型糖尿病。选择标准的一个特点是Lime独立于胰岛素治疗。我们检验这一标准的有效性。研究设计和方法：在9个欧洲中心招募患者，临床医生报告了启动胰岛素的标准。所有患者均在中心实验室检测GAD抗体（GADAs）。我们检查了六个参与中心的gada阳性患者接受胰岛素治疗的时间。结果：胰岛素初始化的标准存在中心间差异。GADA检测中心的中位胰岛素治疗时间为16.15个月（分位间距6.7-25.5），而未常规GADA检测中心的中位胰岛素治疗时间为45.6个月（29.5-61.8）（P < 0.002）。结论：注射胰岛素的时间不应该用来定义LADA患者，因为它依赖于当地的临床判断和使用GADA的实验室检查。
OBJECTIVE - Latent autoimmune diabetes in adults is type I diabetes presenting as noninsulin dependent diabetes. One feature of the selection criteria is Lime independent of insulin treatment. We examine the validity of this criterion.RESEARCH DESIGN AND METHODS - Patients were recruited in nine European centers, and clinicians reported on criteria for initiating insulin. All patients were tested for GAD antibodies (GADAs) in a central laboratory. We examined time to insulin treatment for GADA-positive patients in six participating centers.RESULTS - There was intercenter variation in the criteria used to initiate insulin. Median time to insulin was 16.15 months (interqartile range 6.7-25.5) in centers with GADA testing compared with 45.6 months (29.5-61.8) in centers without routine GADA testing (P < 0.002).CONCLUSION - Time to insulin should not be used to define patients with LADA because it is dependent on local clinical judgment and the use of laboratory tests for GADA.