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[ADA2014]成人糖尿病诊断:T1DM、LADA还是T2DM?
——美国宾夕法尼亚大学Stanley Schwartz教授访谈
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作者:S.Schwartz 2014/6/19 11:06:00    加入收藏
内容概要:《国际糖尿病》:β细胞功能对于糖尿病诊断有着非常重要的价值。我们知道有很多重要的生物标记物,第一个就是谷氨酸脱羧酶,请问现在是否还有其他一些可用于糖尿病诊断的新的生物标记物?
  <International Diabetes> : Dr. Schwartz, we know that the value of beta cell function is very important in the diagnosis of diabetes.  A lot of biomarkers are very important, the first one is glutamic acid decarboxylase, are there any new biomarkers that we can use in the diagnosis of diabetes?
  Dr. Schwartz :Step back for one second, the most important thing to understand is that the beta cell is the core defect in all of diabetes.  In my lecture yesterday we talked about type 1 diabetes, type 2 diabetes, latent autoimmune diabetes in the adult, which has some characteristics of both, and you have heard in the past though there are other core defects like insulin resistance and so forth, they are very important as targets of therapy but the key issue is the beta cell.  What is causing its destruction and what is making it worse and making it lose its ability to secrete insulin over time and cause more destruction.  We would love to be able to identify these people earlier and earlier.  Certainly the classic markers of fasting sugar, postprandial sugar, hemoglobin A1c, and fructosamine is very valuable but we would love to know what other clues we can get in the routine care.  We advocated in our lecture that we use insulin antibodies.  There is a chip out of Stanford that is now supposed to be very inexpensive that gives you a wide screen of antibodies.  We do think either now or in the next 5 years genotyping, which now the cost is relatively inexpensive, maybe

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