Insulin Secretion Capacity as a Crucial Feature to Distinguish Type 1 From Type 2 Diabetes and to Indicate the Need for Insulin Therapy - A Critical Discussion of the ADA/EASD Consensus Statement on the Management of Type 1 Diabetes in Adults.

IF 1.6 4区 医学 Q4 ENDOCRINOLOGY & METABOLISM Experimental and Clinical Endocrinology & Diabetes Pub Date : 2023-09-01 Epub Date: 2023-06-12 DOI:10.1055/a-2016-8392
Andreas Fritsche
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Abstract

In the recently published consensus statement on the treatment and management of type 1 diabetes issued by experts from the American (ADA) and European (EASD) diabetes societies, measurement of endogenous insulin secretion using fasting C-peptide is recommended as a diagnostic criterion. In contrast, our group recently suggested fasting C-peptide/glucose ratio (CGR) for the determination of endogenous insulin secretion. In addition, this ratio may turn out as a potential decision aid for pathophysiologically based differential therapy of diabetes. In this comment, the following points will be discussed: i) CGR as the basis of differential diagnosis of type 1 diabetes, ii) CGR as the basis of treatment decisions for or against insulin in diabetes, and iii) the ease of application of CGR in clinical practice. The use of CGR may complement the ADA/EASD recommendations and should provide a practical application in clinical practice.

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胰岛素分泌能力是区分1型和2型糖尿病的关键特征,并表明需要胰岛素治疗——对成人1型糖尿病管理的ADA/EAD共识声明的批判性讨论。
在美国(ADA)和欧洲(EASD)糖尿病协会的专家最近发表的关于1型糖尿病治疗和管理的共识声明中,建议将使用禁食C肽测量内源性胰岛素分泌作为诊断标准。相反,我们小组最近建议禁食C肽/葡萄糖比率(CGR)来测定内源性胰岛素分泌。此外,这一比例可能成为糖尿病病理生理学差异治疗的潜在决策辅助手段。在这篇评论中,将讨论以下几点:i)CGR作为1型糖尿病鉴别诊断的基础,ii)CGR是糖尿病中胰岛素治疗或抗胰岛素治疗决策的基础,以及iii)CGR在临床实践中的易用性。CGR的使用可以补充ADA/EAD的建议,并应在临床实践中提供实际应用。
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来源期刊
CiteScore
4.10
自引率
5.60%
发文量
72
审稿时长
3 months
期刊介绍: Publishing outstanding articles from all fields of endocrinology and diabetology, from molecular biology to clinical research, this journal is a brilliant resource. Since being published in English in 1983, the popularity of this journal has grown steadily, reflecting the importance of this publication within its field. Original contributions and short communications appear in each issue along with reviews addressing current topics. In addition, supplementary issues are published each year presenting abstracts or proceedings of national and international scientific meetings. The journal was initially published in German and is still the oldest endocrinological periodical in the German-language market!
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