ZINN W J, SCHLEISSNER L A
Calif Med. 1964 Oct;101(4):240-5.
Eighteen diabetic patients were treated with dextrothyroxine (from 2 mg to 8 mg daily) for varying periods up to six months. This produced a decided reduction of serum cholesterol levels. Statistically valid comparisons were made of their fasting blood sugar levels before and after two weeks of dextrothyroxine treatment. Administration of this drug was associated with a significant elevation of fasting blood sugar levels. Good diabetic control did not preclude this adverse effect. After more prolonged treatment with the drug, 8 of the 18 patients experienced progressive deterioration of their diabetic control, necessitating increased amounts of insulin or oral drugs. Despite close observation, one patient developed acidosis. When dextrothyroxine was discontinued, there was a significant drop in blood sugar levels in these patients. Two patients had hypoglycemic reaction. When the fasting blood sugar values of the 18 patients, studied while they were receiving significant doses of dextrothyroxine, are compared with a control series of blood sugar determinations obtained on these same patients before dextrothyroxine administration was begun, the diabetogenic effect of this drug is confirmed by the highly significant difference demonstrated. Four patients were given dextrothyroxine a second time, and again experienced deterioration of diabetic control.
18名糖尿病患者接受了右旋甲状腺素治疗(每日剂量从2毫克至8毫克),治疗时间长达6个月。这使血清胆固醇水平有了明显降低。对他们在接受右旋甲状腺素治疗两周前后的空腹血糖水平进行了具有统计学意义的比较。服用这种药物会使空腹血糖水平显著升高。良好的糖尿病控制并不能避免这种不良反应。在对该药物进行更长时间的治疗后,18名患者中有8名患者的糖尿病控制情况逐渐恶化,需要增加胰岛素或口服药物的用量。尽管进行了密切观察,仍有一名患者发生了酸中毒。当停用右旋甲状腺素时,这些患者的血糖水平显著下降。两名患者出现了低血糖反应。将18名患者在接受大剂量右旋甲状腺素治疗期间所测得的空腹血糖值,与在开始给予右旋甲状腺素治疗之前对这些相同患者进行的血糖测定对照系列进行比较时,该药物的致糖尿病作用通过所显示的高度显著差异得到了证实。4名患者再次接受右旋甲状腺素治疗,糖尿病控制情况再次恶化。