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目的 :通过测定 2型糖尿病中继发性磺脲类药物失效 (SFS)患者的谷氨酸脱羧酶抗体 (GAD Ab) ,探讨SFS与成人迟发型自身免疫性糖尿病 (LADA)的关系。方法 :对 178例SFS患者进行空腹血糖、餐后 2小时血糖、空腹C肽、餐后 2小时C肽、GAD Ab、糖化血红蛋白 (HbA1c)进行测定。结果 :178例SFS患者GAD Ab阳性者 3 4例 ,阳性率 19 10 %。GAD Ab阳性的病人与GAD Ab阴性的病人相比 ,二者发病时的空腹血糖差别不大 ,前者发病年龄较轻 ,体重指数较低 ,空腹及餐后 2小时C肽水平也明显低于后者。GAD Ab阳性患者的餐后 2小时血糖、HbAlc明显高于GAD Ab阴性者 ,说明近 2～ 3个月内病人的血糖总体控制情况较差。结论 :原来诊断为 2型糖尿病而后出现SFS的患者其实有一部分为LADA。表明LADA是 2型糖尿病患者出现SFS的原因之一 ,SFS的原因可能还包含自身免疫因素的参与
OBJECTIVE: To investigate the relationship between SFS and adult delayed-onset autoimmune diabetes (LADA) by measuring glutamic acid decarboxylase antibody (GAD Ab) in patients with secondary sulfonylureas failure (SFS) in type 2 diabetes mellitus. Methods: Fasting blood glucose, 2-hour postprandial blood glucose, fasting C-peptide, 2-hour postprandial C-peptide, GAD Ab and HbA1c were measured in 178 SFS patients. Results: There were 34 positive cases of GAD Ab in 178 SFS patients, with a positive rate of 19 10%. Compared with GAD Ab-negative patients, GAD-Ab-positive patients showed no significant difference in fasting blood glucose at onset, younger age at onset, lower body mass index, and lower fasting and postprandial C-peptide levels at 2 hours By. After 2 hours of postprandial blood glucose, HbAlc was significantly higher in GAD Ab-positive patients than in GAD Ab patients, indicating that the overall blood glucose control was poor in the patients within 2 to 3 months. CONCLUSIONS: In fact, part of the patients diagnosed with type 2 diabetes who subsequently developed SFS were LADA. This suggests that LADA is one of the causes of SFS in patients with type 2 diabetes. The causes of SFS may also include the involvement of autoimmune factors