Clinical features of Japanese type 2 diabetics with insulinogenicindex in normal range after treatment of glucotoxicity
Clinical features of Japanese type 2 diabetics with insulinogenicindex in normal range after treatment of glucotoxicity
复制标题
糖毒性治疗后胰岛素生成指数正常的日本2型糖尿病患者的临床特征
DOI：
10.1007/s13340-011-0046-7
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
et al
中科院分区：
文献类型：
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作者：
Iwahashi H.;et al
据报道，2型糖尿病患者早期胰岛素分泌受损，即使在糖毒性治疗后仍低于正常水平。我们通过对178名日本2型糖尿病患者进行75g口服葡萄糖耐量试验(OGTT)来评估胰岛素分泌情况，这些患者在住院期间通过饮食或胰岛素治疗将糖毒性的影响降至最低。胰岛素分泌指数偏低者16 1例(90.4%)，胰岛素分泌指数正常者17例(9.6%)(I.I.和≥0.4)。这些正常的I.I.组以内脏肥胖和胰岛素抵抗为特征，并表现出胰岛素分泌延迟。与低应答组或正常糖耐量(NGT)组相比，他们的总胰岛素反应显著增加。值得注意的是，在正常静脉注射组中，1名患者在糖毒性治疗后改善到NGT阶段，3名患者改善到糖耐量减低(IGT)。这些结果表明，部分患者在糖毒性治疗后将出现正常的胰岛素生成指数。
Early phase insulin secretion has been reported to be impaired in patients with type 2 diabetes and to remain subnormal even after treatment of the glucotoxicity. We evaluated insulin secretion profiles by performing a 75-g oral glucose tolerance test (OGTT) in 178 Japanese patients with type 2 diabetes after minimizing the influence of glucotoxicity with diet or insulin therapy during hospitalization. Among the 178 patients, 161 (90.4%) had a low insulinogenic index (I.I.; < 0.4) and 17 (9.6%) had an index in the normal range (I.I. ≥ 0.4). This normal I.I. group was characterized by visceral obesity and insulin resistance, and showed delayed insulin secretion. Their total insulin response was significantly increased compared with that of the low response group or the normal glucose tolerance (NGT) group. Strikingly, in the normal I.I. group, one patient improved to the stage of NGT and three to impaired glucose tolerance (IGT) after treatment of the glucotoxicity. These results indicate that some patients will show a normal insulinogenic index after treatment of the glucotoxicity.