Диагностика доклинических стадий сахарного диабета 1 типа: современные подходы к скринингу на островковые антитела

   Цель работы – представить современные подходы к диагностике доклинических стадий сахарного диабета 1 типа (СД1) с использованием скрининга на островковые аутоантитела (АТ).

   Современная концепция предусматривает три стадии этого заболевания: стадия 1 арактеризуется наличием ≥2 АТ при нормогликемии, стадия 2 – наличием ≥2 АТ с дисгликемией, стадия 3 – клинической манифестацией с гипергликемией. Традиционная диагностика СД1 при появлении клинических симптомов приводит к высокой частоте дебюта заболевания с диабетическим кетоацидозом (до 90 % случаев), что ассоциировано с неблагоприятными долгосрочными исходами. Таким образом, представляется актуальным проведение ранней диагностики СД1 на доклинических стадиях. Скрининговые программы с участием родственников первой степени родства пациентов с СД1, лиц с другими аутоиммунными заболеваниями продемонстрировали снижение частоты диабетического кетоацидоза при манифестации на 90 %, что может способствовать сохранению остаточной функции β-клеток и улучшению гликемического контроля в долгосрочном периоде. Внедрение программ ранней диагностики и наблюдения людей на доклинических стадиях СД1 являются ключевыми направлениями изменения траектории заболевания и улучшения прогноза пациентов.

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