緩徐進行 1 型糖尿病疑い例への治療介入に関するステートメント

Insulin treatment should be introduced for patients with slowly progressive insulin-dependent diabetes mellitus (SPIDDM) according to the revised diagnostic criteria of SPIDDM (2023). However, SPIDDM (probable) cases are in a non-insulin-dependent state, so more flexible treatment can be considered, although sulphonylurea agents should be avoided. Insulin treatment helps maintain the intrinsic insulin secretion capacity, but this does not mean that all SPIDDM (probable) cases should use insulin from the early phase. However, while DPP4 inhibitors and biguanides can be selected for treating SPIDDM (probable), no evidence yet exists concerning the efficacy of other hypoglycemic agents. Careful monitoring of the intrinsic insulin secretion capacity should therefore be performed, and if a reduction in the intrinsic insulin secretion capacity is suspected, changing the treatment should be considered in order to prevent progression to an insulin-dependent state.