Shield J P H, Temple I K, Sabin M, Mackay D, Robinson D O, Betts P R, Carson D J, Cavé H, Chevenne D, Polak M
St Michael's Hill, Bristol BS2 8BJ, UK.
Arch Dis Child Fetal Neonatal Ed. 2004 Jul;89(4):F341-3. doi: 10.1136/adc.2003.030502.
To examine derived indices of beta cell function, peripheral insulin sensitivity, and the pancreatic response to intravenous glucose loading in children with a previous history of transient neonatal diabetes currently in remission, repeated after a period of two or more years.
The standard intravenous glucose tolerance test (IVGTT) was used to measure the first phase insulin response (FPIR) cumulatively at one and three minutes. In addition, fasting insulin and glucose values were used to estimate insulinogenic indices (beta cell function) and QUICKI (insulin sensitivity).
Six patients with known previous transient neonatal diabetes currently in remission with no exogenous insulin requirement were tested. Control data from 15 children of a similar age were available for derived fasting indices of beta cell functional capacity and insulin sensitivity.
One child had a subnormal insulin secretory response to intravenous glucose that remained abnormal two and four years later. The other children had relatively normal or entirely normal responses over two years. Measures of beta cell function and insulin sensitivity in the fasting state showed comparable results to those obtained from normal controls.
Most children with transient neonatal diabetes in remission have no evidence of beta cell dysfunction or insulin resistance in the fasting state, although they might have been expected to show subtle defects given the tendency to relapse in adolescence. Measures of insulin response to intravenous glucose loading are often normal but suggest future recurrence if profoundly abnormal.
对既往有短暂性新生儿糖尿病病史且目前处于缓解期的儿童，在两年或更长时间后重复检测其β细胞功能、外周胰岛素敏感性以及胰腺对静脉注射葡萄糖负荷的反应的衍生指标。
采用标准静脉葡萄糖耐量试验（IVGTT），在1分钟和3分钟时累积测量第一阶段胰岛素反应（FPIR）。此外，空腹胰岛素和葡萄糖值用于评估胰岛素生成指数（β细胞功能）和QUICKI（胰岛素敏感性）。
对6例既往有短暂性新生儿糖尿病病史且目前处于缓解期、无需外源性胰岛素治疗的患者进行了检测。可获得15名年龄相仿儿童的对照数据，用于β细胞功能能力和胰岛素敏感性的空腹衍生指数。
1名儿童对静脉注射葡萄糖的胰岛素分泌反应低于正常水平，在两年和四年后仍未恢复正常。其他儿童在两年内的反应相对正常或完全正常。空腹状态下的β细胞功能和胰岛素敏感性测量结果与正常对照组相当。
大多数处于缓解期的短暂性新生儿糖尿病儿童在空腹状态下没有β细胞功能障碍或胰岛素抵抗的证据，尽管考虑到青春期复发的倾向，他们可能会出现细微缺陷。静脉注射葡萄糖负荷后的胰岛素反应测量通常正常，但如果严重异常则提示未来可能复发。
