磺脲类药物所致低血糖症中的胰岛素和C肽水平：一项系统评价

Insulin & C-peptide levels in sulfonylurea-induced hypoglycemia: a systematic review.

作者信息

DeWitt Christopher R, Heard Kennon, Waksman Javier C

机构信息

Saint Paul's Hospital, Division of Emergency Medicine, Vancouver, BC, Canada.

出版信息

J Med Toxicol. 2007 Sep;3(3):107-18. doi: 10.1007/BF03160920.

DOI:10.1007/BF03160920

PMID:18072146

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3550061/

Abstract

OBJECTIVES

We will describe insulin and C-peptide levels observed in sulfonylurea-induced hypoglycemia and determine whether these levels differed if obtained before or after hypoglycemic therapy.

METHODS

We performed a systematic review of the English literature to identify Medline articles containing "sets" (glucose <60 mg/dL with insulin and C-peptide levels). These "sets" were categorized as being obtained BEFORE, AFTER, or UNKNOWN with respect to hypoglycemic therapy.

RESULTS

22 articles, 76 patients, and 97 "sets" were included. Mean glucose (mg/dL), insulin (muIU/mL), and C-peptide (ng/mL) for all "sets' were 28.6 (+/-12.6; 26.1 to 31.2), 54.4 (+/-126.3; 28.3 to 80.5), 7.2 (+/-6.2; 5.9 to 8.5). The BEFORE measures were 24.3 (+/-7.3; 18.7 to 30.0), 36.6 (+/-26.2; 16.5 to 56.7), 5.4 (+/-4.6; 1.5 to 9.2). The AFTER measures were 33.1 (+/-9.8; 28.2 to 38.0), 126.7 (+/-278.1; 0 to 265.0), 10.3 (+/-10.5; 5.1 to 15.4). The UNKNOWN measures were 28.0 (+/-13.5; 24.7 to 31.3), 37.1 (+/-21.8; 31.7 to 42.5), 6.5 (+/-4.3; 5.4 to 7.6). Only one "set" (glucose 49 mg/dL) had insulin <3.9 muIU/mL and C-peptide <1.4 ng/mL.

CONCLUSIONS

Insulin > or =3.9 muIU/mL, C-peptide > or =1.4 ng/mL, and glucose <49 mg/dl are consistent with sulfonylurea-induced hypoglycemia. BEFORE levels were lower, but they were consistent with sulfonylurea-induced hypoglycemia.

摘要

目的

我们将描述在磺脲类药物引起的低血糖症中观察到的胰岛素和C肽水平，并确定这些水平在低血糖治疗之前或之后获取时是否存在差异。

方法

我们对英文文献进行了系统回顾，以识别包含“数据组”（血糖<60mg/dL以及胰岛素和C肽水平）的Medline文章。这些“数据组”根据低血糖治疗情况被分类为在治疗前、治疗后或情况不明时获取。

结果

纳入了22篇文章、76名患者和97个“数据组”。所有“数据组”的平均血糖（mg/dL）、胰岛素（muIU/mL）和C肽（ng/mL）分别为28.6（±12.6；26.1至31.2）、54.4（±126.3；28.3至80.5）、7.2（±6.2；5.9至8.5）。治疗前测量值为24.3（±7.3；18.7至30.0）、36.6（±26.2；16.5至56.7）、5.4（±4.6；1.5至9.2）。治疗后测量值为33.1（±9.8；28.2至38.0）、126.7（±278.1；0至265.0）、10.3（±10.5；5.1至15.4）。情况不明的测量值为28.0（±13.5；24.7至31.3）、37.1（±21.8；31.7至42.5）、6.5（±4.3；5.4至7.6）。只有一个“数据组”（血糖49mg/dL）的胰岛素<3.9muIU/mL且C肽<1.4ng/mL。