Development of disorders of carbohydrate metabolism in patients with slowly progressive autoimmune diabetes of adults in the dynamics of the disease
T.M. TIKHONOVA
V.Y. Danylevsky Institute for Endocrine Disorder Research of the National Academy of Medical Sciences of the Ukraine, 10 Artem St., Kharkov, the Ukraine 61002
Tikhonova T.M. — Cand. Med. Sc., senior researcher of the Department of Age-Related Endocrinology, tel. +38057-315-11-88, e-mail: tanya_tykhonova@mail.ru
The study involved 262 patients with diabetes mellitus (DM), where 121 patients were diagnosed the «slowly progressive autoimmune diabetes in adults», 60 patients — diabetes mellitus of the 1st type, 81 patients — diabetes mellitus of the 2nd type. It was determined that despite the similarity of the clinical manifestations of slowly progressive autoimmune diabetes in adults and diabetes mellitus of the 2nd type, the glycemic level in the definition of the disease in patients with slowly progressive autoimmune diabetes is significantly higher. Growing inefficiency of peroral hypoglycemic therapy in patients with slowly progressive autoimmune diabetes in terms of 2,61±0,15 years from the onset of complaints justifies the feasibility of a timely prescription of the insulin therapy. The prescription of insulin to patients with slowly progressive autoimmune diabetes leads to a significant reduction of carbohydrate metabolism. Therapy witn insulin in patients with slowly progressive autoimmune diabetes is accompanied by also more stable course of the disease and better compensation than in patients with diabetes mellitus of the 1st type.
Key words: slowly progressive autoimmune diabetes, carbohydrate metabolism.
REFERENCES
- Dedov I.I., Shestakova M.V. Sakharnyy diabet: diagnostika, lechenie, profilaktika [Diabetes: diagnosis, treatment, prevention]. Moscow, 2011. 808 p.
- Aschner P.J., Ruiz A.J. Metabolic memory for vascular disease in diabetes. Diabetes. Technol. Ther., 2012, vol. 14, suppl. 1, rr. 68-74, available at: http://www.ncbi.nlm.nih.gov/pubmed?term=Diabetic%20Nephropathy%20Study%20Group%20of%20the%20Austrian%20Society%20of%20Nephrology%5BCorporate%20Author%5D
- Zimmet P.Z., Tuomi T., Mackay vet al. Latent autoimmune diabetes mellitus in Adults (LADA): the Role of Antibodies to Glutamic Acid Decarboxylase in Diagnosis and Prediction of Insulin Dependency. Diabetic Medicine, 1994, vol. 11. pp. 299-303.
- Pozzilli P., Di Mario U. Autoimmune diabetes not requiring insulin at diagnosis (Latent autoimmune diabetes of the adult). Definition, characterization, and potential prevention. Diabetes Care, 2001, vol. 24, no. 8, pp. 1460-1467.
- Kononenko I.V., Prokof’ev S.A., Smirnova O.M. Functional state β-cells, immunological, clinical and biochemical characteristics of patients with slowly progressive autoimmune diabetes of adults. Problemy endokrinologii, 2004, vol. 50, no. 1, pp. 18-22 (in Russ.).
- Desai M., Clark A. Latent autoimmune diabetes in adults: lessons from UKPDS. Diabet. Med., 2008, vol. 25, suppl. 2, pp. 30-34.
- Bell D.S., Ovalle F. The Role of C-Peptide Levels in Screening for Latent Autoimmune Diabetes in Adults. Am. J. Ther, 2004, vol. 11(4), pp. 308-311.
- Stenström G., Gottsäter A., Bakhtadze E. et al. Latent Autoimmune Diabetes in Adults. Definition, Prevalence, β-Cell Function, and Treatment. Diabetes, 2005, vol. 54, suppl. 2, pp. 68-72.
- Tuomi T., Carlson A.L., Li H.et al. Clinical and genetic characteristics of type 2 diabetes with and without GAD antibodies. Diabetes, 1999, vol. 48, pp. 150-157.
- Tuomi T., Groop L.C., Zimmet P.Z. et al. Antibodies to glutamic acid decarboxylase reveal latent autoimmune diabetes mellitus in adults with a non-insulin-dependent onset of disease. Diabetes, 1993, vol. 42(2), pp. 359-62.
- Solov’eva O. E. Osobennosti debyuta i razvitiya sosudistykh oslozhneniy u bol’nykh medlenno progressiruyushchim autoimmunnym diabetom vzroslykh: dis. … kand. med. nauk [Features debut and development of vascular complications in patients with slowly progressive autoimmune diabetes of adults. Dis. PhD Med. sci.]. Moscow, 2002. 125 p.
- Lutgens M.W., Meijer M., Peeters B. et al. Easily obtainable clinical features increase the diagnostic accuracy for latent autoimmune diabetes in adults: an evidence-based report. Poulsen MLPrim Care Diabetes, 2008, vol. 2(4), pp. 207-11.
- Andersen C.D., Bennet L., Nyström L. et al. Worse glycaemic control in LADA patients than in those with type 2 diabetes, despite a longer time on insulin therapy. Diabetologia, 2013, vol. 56(2), pp. 252-8.
- Isomaa B., Almgren P., Henricsson M. et al. Chronic complications in patients with slowly progressing autoimmune type 1 diabetes (LADA). Diabetes Care, 1999, vol. 22, no. 8, pp. 1347-1353.
- Arikan E., Sabuncu T., Ozer E.M., Hatemi H. The clinical characteristics of latent autoimmune diabetes in adults and its relation with chronic complications in metabolically poor controlled Turkish patients with Type 2 diabetes mellitus. J. Diabetes Complications, 2005, vol. 19(5), pp. 254-8.
- Pozdnyak A.O. Latent autoimmune diabetes of adults (LADA): issues and prospects for treatment. Meditsinskiy al’manakh, 2008, no. 4, pp. 170-172 (in Russ.).