Larsen S, Hilsted J, Philipsen E K, Tronier B, Damkjaer Nielsen M, Worning H
Medical Department F, Glostrup Hospital, University of Copenhagen, Denmark.
Acta Endocrinol (Copenh). 1991 May;124(5):510-5. doi: 10.1530/acta.0.1240510.
Insulin was withdrawn from 7 patients with Type I (insulin-dependent) diabetes and 4 patients with insulin-dependent diabetes secondary to chronic pancreatitis, both groups without residual beta-cell function. Median plasma glucagon concentrations rose slightly, but significantly after withdrawal of insulin in Type I diabetic patients (from 14 (range: 11-16) to 19 (14-25) pmol/l by 6 h), but not in the patients with secondary diabetes. This was accompanied by a significantly higher increase in blood glucose concentration from 5.1 (4.9-5.7) to 15.2 (12.9-18.1) mmol/l by 6 h in Type I diabetic patients compared with patients with secondary diabetes (from 4.9 (4.3-6.7) to 13.1 (10.9-13.5) mmol/l) (p less than 0.01). Beta-hydroxybutyrate increased to a similar extent in the two groups, whereas no significant increases were found in glycerol and lactate in any of the groups. Increased secretion of glucagon is not essential for the development of hyperglycemia and ketonemia in patients with diabetes secondary to chronic pancreatitis, but may augment the degree of hyperglycemia in Type I diabetic patients compared with patients having secondary diabetes.
对7例1型（胰岛素依赖型）糖尿病患者和4例继发于慢性胰腺炎的胰岛素依赖型糖尿病患者停用胰岛素，这两组患者均无残余β细胞功能。1型糖尿病患者停用胰岛素后，血浆胰高血糖素浓度中位数略有上升，但6小时后显著上升（从14（范围：11 - 16）pmol/L升至19（14 - 25）pmol/L），而继发糖尿病患者则未出现这种情况。与之相伴的是，1型糖尿病患者血糖浓度在6小时内从5.1（4.9 - 5.7）mmol/L显著升至15.2（12.9 - 18.1）mmol/L，相比之下，继发糖尿病患者血糖浓度从4.9（4.3 - 6.7）mmol/L升至13.1（10.9 - 13.5）mmol/L（p<0.01）。两组中β-羟丁酸升高程度相似，而两组中甘油和乳酸均未显著升高。胰高血糖素分泌增加对于继发于慢性胰腺炎的糖尿病患者高血糖和酮血症的发生并非必要，但与继发糖尿病患者相比，可能会加剧1型糖尿病患者的高血糖程度。
