Lele R D
Nuclear Medicine Department, Jaslok Hospital and Research Centre, Mumbai, India.
J Assoc Physicians India. 2010 Jan;58:30, 35-40.
This article emphasizes (1) the utility of routine measurement of pro-insulin to insulin ratio as a specific marker of insulin resistance and predictor of future T2DM, HT and CAD, (2) routine C-Peptide estimation to determine which T2DM needs insulin and to monitor the effect of newer drugs which promote beta cell regeneration, (3) routine estimation of adiponectin and TNF alpha and monitor response to thiozolidine drugs which increases adiponectin and decreases TNF alpha production by adipocytes, (4) crucial role of AMPK--Cellular energy sensor in mediating the beneficial effects of exercise as well as drugs (adiponectin, metformin) in T2DM, (5) Availability of glucogon suppressors will eliminate the need for giving insulin to T2 DM with normal C Pepetide levels which inevitably causes undesirable weight gain & hypoglycemia.
（1）常规测量胰岛素原与胰岛素比值作为胰岛素抵抗的特异性标志物以及未来2型糖尿病、高血压和冠心病的预测指标的实用性；（2）常规进行C肽评估，以确定哪些2型糖尿病患者需要胰岛素，并监测促进β细胞再生的新型药物的效果；（3）常规评估脂联素和肿瘤坏死因子α，并监测噻唑烷类药物的反应，这类药物可增加脂联素并减少脂肪细胞产生肿瘤坏死因子α；（4）AMPK（细胞能量传感器）在介导运动以及药物（脂联素、二甲双胍）对2型糖尿病的有益作用中起关键作用；（5）胰高血糖素抑制剂的可用性将消除对C肽水平正常的2型糖尿病患者注射胰岛素的需求，胰岛素注射不可避免地会导致不良的体重增加和低血糖。
