RESUMO
Objective To investigate the effect of rosiglitazone and insulin on islet ? cell function in latent autoimmune diabetes in adults (LADA). Methods Glutamic acid decarboxylase (GAD) antibody was screened in patients initially diagnosed type 2 diabetes. LADA patients, defined as positive GAD antibody and with a fasting C peptide of 300 pmol/L or more, were selected and randomly assigned to receive subcutaneous insulin alone ( n =6) or rosiglitazone combined with insulin ( n =6) to compare the changes of islet ? cell function. At entry and 1 year after treatment, blood was drawn to determine plasma glucose, HbA 1c and C peptide at fasting and 2 hours after taking 75 g glucose without medication. GAD antibody and C peptide were measured with radioligand immunoassay and radioimmune assay respectively. Results After 1 year treatment, LADA patients in rosiglitazone and insulin group had a higher postprandial C peptide than those in subcutaneous insulin group(782.1 pmol/L vs 1 695.0 pmol/L, P
RESUMO
Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.