Vlasáková Z, Bartos V, Spicák J
Centrum diabetologie, Institut klinické a experimentální medicíny, Praha.
Vnitr Lek. 2002 Sep;48(9):878-81.
Diabetes mellitus as a specific etiological type of disease is a relatively frequent complication of chronic pancreatitis and is found always after total pancreatectomy. It is not clear whether in the frequently profound hypoglycaemias of these patients also increased insulin sensitivity may participate. Data in the literature are not uniform. The objective of the submitted work was to assess the insulin sensitivity in 10 patients with chronic pancreatitis (confirmed by ERCP) and diabetes and to compare them with 10 controls and 10 diabetics type 2 treated by diet matched for age and body mass index. The effect of insulin was assessed by the method of the 3-hour hyperinsulin euglycaemic clamp (insulin level 75 microU/ml, blood sugar level 5 mmol/l) acording to glucose consumption as glucose Mglu, glucose clearance MCRglu and insulin sensitivity index SI. Patients with pancreatic diabetes did not differ from controls and type 2 diabetics resp. as regards fasting insulin, C peptide level and lipid parameters. The groups did not differ as regards the glucagon level. Patients with chronic pancreatitis and diabetes had a lower insulin sensitivity than healthy controls.
糖尿病作为一种特定病因类型的疾病,是慢性胰腺炎相对常见的并发症,且总是在全胰切除术后出现。目前尚不清楚在这些患者频繁出现的严重低血糖症中,胰岛素敏感性增加是否也起作用。文献中的数据并不一致。本研究的目的是评估10例经内镜逆行胰胆管造影(ERCP)确诊的慢性胰腺炎合并糖尿病患者的胰岛素敏感性,并将其与10例对照者以及10例年龄和体重指数匹配的接受饮食治疗的2型糖尿病患者进行比较。通过3小时高胰岛素正常血糖钳夹技术(胰岛素水平75微单位/毫升,血糖水平5毫摩尔/升),根据葡萄糖消耗量计算葡萄糖Mglu、葡萄糖清除率MCRglu和胰岛素敏感性指数SI来评估胰岛素的作用。胰腺性糖尿病患者在空腹胰岛素、C肽水平和脂质参数方面与对照组及2型糖尿病患者无差异。各组在胰高血糖素水平方面也无差异。慢性胰腺炎合并糖尿病患者的胰岛素敏感性低于健康对照组。