Wolfsheimer K J
Department of Veterinary Physiology, Pharmacology & Toxicology, School of Veterinary Medicine, Lousiana State University, Baton Rouge 70803.
Probl Vet Med. 1990 Dec;2(4):591-601.
Insulin resistance is a cause for morning hyperglycemia seen in diabetic patients. Other reasons for morning hyperglycemia should be eliminated by performing an insulin response test. Once insulin resistance has been established as the cause of hyperglycemia, a step-by-step process should be used to establish the cause of the insulin resistance. Common causes of insulin resistance include hyperadrenocorticism, acromegaly, hyperthyroidism, and obesity. Hepatic disease, renal insufficiency, and sepsis are other causes of insulin resistance in practice. Less common causes include insulin antibodies, pregnancy, neoplasia, hyperandrogenism, and pheochromocytoma. If the underlying cause cannot be found or resolved, then increased doses of insulin are required to manage the hyperglycemia.
胰岛素抵抗是糖尿病患者出现清晨高血糖的一个原因。应通过进行胰岛素反应试验排除清晨高血糖的其他原因。一旦确定胰岛素抵抗是高血糖的病因，就应采用逐步的方法来确定胰岛素抵抗的原因。胰岛素抵抗的常见原因包括肾上腺皮质功能亢进、肢端肥大症、甲状腺功能亢进和肥胖。在实际情况中，肝脏疾病、肾功能不全和脓毒症是胰岛素抵抗的其他原因。不太常见的原因包括胰岛素抗体、妊娠、肿瘤、高雄激素血症和嗜铬细胞瘤。如果找不到或无法解决潜在病因，那么就需要增加胰岛素剂量来控制高血糖。
