【摘要】 对成人晚发自身免疫性糖尿病（LADA）早期诊断，用胰岛素治疗，有利于保护残留部分胰岛β细胞功能，延缓病情的发展。本文通过对三组病人及一组正常者，用酶免疫和放射免疫法测定血糖、血清C肽、血清谷氨酸脱梭酶抗体（GAD-Ab），比较其相关性，得出LADA实验室诊断指标。对新发病的糖尿病病人，年龄20-40岁，发病时"三多"症状明显，口服降糖药血糖难以控制，无诱因而出现酮体，应测空腹血糖、C肽，馒头餐后1小时、2小时C肽，并测GAD-Ab。若空腹血糖大于13．0mmol／L，空腹C肽小于0．5nmol／L，餐后1小时、2小时C肽均低于0．85nmol／L，且GAD-Ab阳性者，可诊断为LADA；若GAD-Ab阴性，但空腹血糖很高，空腹及餐后1小时、2小时C肽明显低于正常，也应高度怀疑为LADA。更多还原

【Abstract】 The remainder insular β cell function could be protected if LADA had been earlydiagnosed and treated by insulin. We contrasted the blood －glucose, serum C －peptide and GAD－Ah, which had been measured by enzyｍe immunoassay and radioimmunoassay in three patientgroups and one normal group, and obtained the index of LADA laboratory diagnosis. For new dia　betic patients, the fasting blabs -- glucose and C -- peptide should be measured when they have haddefinite symptom Of diabetes, incoercible blood -- glucose by drugs and ketone bodies withoutreasons. LADA can be diagnosed when fasting blood -- glucose is above 13. ommol/L, fasting C peptide is below 0. snmoVL, GAD -- Ah is POSitive and C -- peptide is below 0. 85nmol/L one hourand two hours after diet. LADA shoud be highly doubted when GAD -- Ah is negative, but fastingblood -- glucose is high, C -- peptide of fasting one hour and two hours after diet is obviously lowerthan normal.更多还原