If abnormal blood glucose levels are found, diabetes is the first thing to consider, both the patient and the doctor. However, some patients, despite regular testing, regular medication, and efforts to make lifestyle changes, have difficulty controlling fluctuations in blood sugar levels. In this case, it is necessary to conduct a comprehensive examination in time to find the real root cause from the perspective of autoimmunity, especially the need to pay attention to insulin resistance syndrome. Only when it is clear that the black hand behind the influence on blood glucose levels can targeted measures be taken to tame blood sugar.
There are many types of autoimmune factors that cause blood sugar fluctuations. Let's first talk about adult occult autoimmune diabetes, which is referred to as LADA for short. Relevant survey data show that the prevalence of LADA in the first diagnosed cases of adult type 2 diabetes among our compatriots is about 6%. In such patients, susceptibility genes for both type 1 and type 2 diabetes may be present, mainly manifested by the presence of multiple autoantibodies, the most common being glutamate decarboxylase antibody GADA.
Patients with occult autoimmune diabetes are susceptible to concomitant thyroid disorders, such as Hashimoto's thyroiditis or hypothyroidism. Patients with LADA are usually older than 18 years, positive for islet autoantibodies, and do not rely on insulin therapy for more than 6 months after diagnosis. In the case of this type of diabetes, sulfonylureas, such as U-hypoglycemic or deltacorn, should be avoided. If islet autoantibodies have high titers and poor metabolic status, insulin therapy is indicated as soon as possible.
Let's talk about insulin autoimmune syndrome. The disease is short for IAS, also known as type C insulin resistance syndrome. Typically presents with episodic hypoglycemia, or persistent hyperglycemia. Blood test results, showing high titers of insulin autoantibodies. Because antibodies bind to insulin in the serum, insulin is inactive, leading to insulin resistance and postprandial hyperglycemia. In addition, due to insulin autoantibodies, it can be uncontrolled dissociation from insulin, resulting in a sudden increase in insulin levels, which can induce hypoglycemia.
It is important to note that IAS can lead to extreme insulin resistance and can be classified into different types, such as defective insulin receptor genes, or fat-shrinking diabetes mellitus, loss of subcutaneous adipose tissue, and triglyceridemia. In addition, drugs for the treatment of hyperthyroidism, methimazole, may induce IAS, such patients may have both hyperthyroidism and hypoglycemia manifestations, discontinuation of methamidazole, and after dietary adjustment, the symptoms of hypoglycemia will be significantly relieved.
Let's take a look at type B insulin resistance syndrome, the abbreviation of this disease is TBIRS, is a kind of severe insulin resistance, the cause is the presence of antibodies against insulin receptors in the blood circulation, which belongs to autoimmune syndrome. The main manifestations are hyperglycemia, hyperinsulinemia, acanthosis nigricans, refractory hypoglycemia, and most patients will also develop autoimmune diseases such as systemic lupus erythematosus.
At present, the academic community believes that type B insulin resistance syndrome is the result of the body's immunomodulatory disorders, and the diagnosis of this disease requires the detection of insulin receptor antibodies. TBIRS, the incidence is very low, usually female patients, patients will have increased hair and acanthosis nigricans, increased blood glucose after meals, blood tests will find accelerated erythrocyte sedimentation rate, positive for a variety of rheumatic antibodies, increased immunoglobulins and other indicators of change. Immunomodulators and glucocorticoids are needed to cope with this disease. By recognizing the different types of insulin resistance, we hope to help everyone establish a sense of 1 kind, do not blindly regard abnormal blood sugar levels as type 2 diabetes, especially when finding the characteristics of autoimmune diseases, a comprehensive examination is needed. It is important to note that although the incidence of blood glucose fluctuations caused by immune factors is not high, if the response strategy is wrong, management and treatment according to ordinary type 2 blood glucose urine will not only delay the disease, but also may cause serious consequences. Therefore, when you find that you can't control your blood sugar when you take medication regularly, the first thing to do is to diagnose the cause.
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