ROLE OF RESIDUAL INSULIN-SECRETION IN PROTECTING AGAINST KETOACIDOSIS IN INSULIN-DEPENDENT DIABETES
ROLE OF RESIDUAL INSULIN-SECRETION IN PROTECTING AGAINST KETOACIDOSIS IN INSULIN-DEPENDENT DIABETES
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DOI：
10.1136/bmj.2.6200.1257
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发表时间：
1979-01-01
影响因子：
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通讯作者：
REGEUR, L
中科院分区：
文献类型：
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作者：
MADSBAD, S;ALBERTI, KGMM;REGEUR, L
根据C-肽浓度，对8例有胰岛β细胞功能残留者和7例无胰岛β细胞残留者评估了保留的胰岛β细胞功能在预防I型胰岛素依赖型糖尿病患者酮症酸中毒中的作用。在胰岛素分泌12小时后，没有β细胞功能的患者的脂肪酸和甘油浓度都显著高于有残余分泌物的患者。第一组平均血糖浓度为17.2+/-SE，平均1.3 mmo1/L(310+/-23 mg/100ml)，而第二组为8.8+/-1.4 mmo1/L(159+/-25 mg/100ml)(P<0.01)。3-羟丁酸浓度分别升至5.5+/-mmo1/L(57+/-5 mg/100ml)和1.4+/-0.3 mmo1/L(15+/-3 mg/100ml)(P<0.01)。个体平均C肽浓度与血糖值呈显著负相关(r=-0.91；P<0.02)。这些发现有力地表明，即使是最少量的残余胰岛素分泌对糖尿病患者的代谢健康也是重要的，并可能在胰岛素供应不足时防止严重的酮症酸中毒的发生。
The role of preserved beta-cell function in preventing ketoacidosis in type I insulin-dependent diabetes was assessed in eight patients with and seven patients without residual beta-cell function as determined from C-peptide concentrations. After 12 hours of insulin fatty-acid, and glycerol concentrations were all significantly higher in patients without beta-cell function than in those with residual secretion. Mean blood glucose concentrations reached 17.2 +/- SE of mean 1.3 mmol/l (310 +/- 23 mg/100 ml) in the first group compared with 8.8 +/- 1.4 mmol/l (159 +/- 25 mg/100 ml) in the second (P less than 0.01), while 3-hydroxybutyrate concentrations rose to 5.5 +/- mmol/l (57 +/- 5 mg/100 ml) and 1.4 +/- 0.3 mmol/l (15 +/- 3 mg/100 ml) in the two groups respectively (P less than 0.01). Individual mean C-peptide concentrations showed a significant inverse correlation with the final blood glucose values (r = -0.91; P less than 0.02). These findings strongly suggest that even minimal residual insulin secretion is important for metabolic wellbeing in diabetes and may prevent the development of severe ketoacidosis when insulin delivery is inadequate.