Hother-Nielsen O, Beck-Nielsen H
Medical Department 3, Aarhus Amtssygehus, Denmark.
Acta Endocrinol (Copenh). 1991 Jun;124(6):637-45. doi: 10.1530/acta.0.1240637.
Fasting hyperglycemia in Type II (non-insulin-dependent) diabetes has been suggested to be due to hepatic overproduction of glucose and reduced glucose clearance. We studied 22 patients (10 lean and 12 obese) with newly diagnosed mild diabetes mellitus (fasting plasma glucose less than 15 mmol/l, urine ketone bodies less than 1 mmol/l), and two age- and weight-matched groups of non-diabetic control subjects. Glucose turnover rates and sensitivity to insulin were determined using adjusted primed-continuous [3-3H]glucose infusion and the hyperinsulinemic euglycemic clamp technique. Insulin-stimulated glucose utilization was reduced in both diabetic groups (lean patients: 313 +/- 35 vs 531 +/- 22 mg.m-2.min-1, p less than 0.01; obese patients: 311 +/- 28 vs 453 +/- 26 mg.m-2.min-1, p less than 0.01). Basal plasma glucose concentrations decreased 0.43 +/- 0.05 mmol/l per h (p less than 0.01). Glucose production rates were smaller than glucose utilization rates (lean patients: 87 +/- 3 vs 94 +/- 3 mg.m-2.min-1, p less than 0.01; obese patients: 79 +/- 5 vs 88 +/- 5 mg.m-2.min-1, p less than 0.01), were not correlated to basal glucose or insulin concentrations, and were not different from normal (lean controls: 87 +/- 4 mg.m-2.min-1; obese controls: 80 +/- 5 mg.m-2.min-1). These results suggest that the basal state in the diabetic patients is a compensated condition where glucose turnover rates are maintained near normal despite defects in insulin sensitivity.
II型（非胰岛素依赖型）糖尿病患者的空腹血糖升高被认为是由于肝脏葡萄糖生成过多和葡萄糖清除率降低所致。我们研究了22例新诊断的轻度糖尿病患者（10例体型瘦者和12例肥胖者，空腹血浆葡萄糖低于15 mmol/l，尿酮体低于1 mmol/l），以及两组年龄和体重匹配的非糖尿病对照受试者。使用调整后的单次静脉注射-连续[3-3H]葡萄糖输注和高胰岛素正常血糖钳夹技术测定葡萄糖周转率和胰岛素敏感性。两组糖尿病患者的胰岛素刺激的葡萄糖利用率均降低（体型瘦者患者：313±35对531±22 mg·m-2·min-1，p<0.01；肥胖患者：311±28对453±26 mg·m-2·min-1，p<0.01）。基础血浆葡萄糖浓度每小时下降0.43±0.05 mmol/l（p<0.01）。葡萄糖生成率小于葡萄糖利用率（体型瘦者患者：87±3对94±3 mg·m-2·min-1，p<0.01；肥胖患者：79±5对88±5 mg·m-2·min-1，p<0.01），与基础血糖或胰岛素浓度无关，且与正常情况无差异（体型瘦者对照：87±4 mg·m-2·min-1；肥胖对照：80±5 mg·m-2·min-1）。这些结果表明，糖尿病患者基础状态是一种代偿状态，尽管胰岛素敏感性存在缺陷，但葡萄糖周转率仍维持在接近正常水平。
