Eldor Roy, Stern Erwin, Milicevic Zvonko, Raz Itamar
Diabetes Research Center, Department of Medicine, Hadassah-Hebrew University Hospital, Jerusalem 91120, Israel.
Diabetes Res Clin Pract. 2005 Jun;68 Suppl1:S30-5. doi: 10.1016/j.diabres.2005.03.004. Epub 2005 Mar 31.
Type 2 diabetes is a disease characterised by peripheral insulin resistance, as well as by pancreatic beta cell dysfunction. This process is in part due to elevated blood glucose and free fatty acids--termed glucolipotoxicity. The traditional pathway of treating type 2 diabetes in a stepwise manner, beginning with life style modifications and continuing with oral hypoglycaemic agents leads to a protracted period of unnecessary hyperglycaemia. A new approach, targeted at alleviating the deleterious effects of hyperglycaemia and elevated free fatty acids by acutely lowering both with intensive insulin therapy, has yielded prolonged remissions in therapy in which only diet was necessary to maintain normoglycaemia. This new approach, its rationale, benefits and misgivings are discussed in this review.
2型糖尿病是一种以周围胰岛素抵抗以及胰腺β细胞功能障碍为特征的疾病。这个过程部分归因于血糖和游离脂肪酸升高，即所谓的糖脂毒性。传统的逐步治疗2型糖尿病的方法，从生活方式改变开始，接着使用口服降糖药，会导致一段不必要的长期高血糖期。一种新方法，通过强化胰岛素治疗迅速降低血糖和升高的游离脂肪酸，以减轻高血糖和游离脂肪酸升高的有害影响，在仅需饮食就能维持血糖正常的治疗中产生了长期缓解。本综述讨论了这种新方法、其原理、益处和疑虑。
