Raskin P, Stevenson M R, Barilla D E, Pak C Y
Clin Endocrinol (Oxf). 1978 Oct;9(4):329-35. doi: 10.1111/j.1365-2265.1978.tb02218.x.
Calcium and phosphous metabolism was investigated in 20 patients with diabetes mellitus when their diabetes was under poor metabolic control and again once optimal glycaemic control was achieved with aggressive insulin therapy. Ten of the twenty uncontrolled diabetics had hypercalciuria; insulin therapy returned calcium excretion to normal in five. Twenty-four hour calcium excretion fell in all but two patients when optimal diabetic control was achieved and calcium excretion was positively correlated with glucose excretion. Urinary cyclic AMP excretion, which was in the high normal range during poor control, decreased significantly during optimal insulin therapy. These data suggest that the hypercalciuria of uncontrolled diabetes may be a form of renal hypercalciuria which could result in parathyroid stimulation which might contribute to the development of osteopenia in patients with diabetes mellitus.
对20例糖尿病患者在代谢控制不佳时以及通过强化胰岛素治疗实现最佳血糖控制后再次进行钙和磷代谢研究。20例未得到控制的糖尿病患者中有10例出现高钙尿症；胰岛素治疗使5例患者的钙排泄恢复正常。在实现最佳糖尿病控制时，除2例患者外，所有患者的24小时钙排泄量均下降，且钙排泄与葡萄糖排泄呈正相关。在控制不佳时处于高正常范围的尿环磷酸腺苷排泄量在最佳胰岛素治疗期间显著降低。这些数据表明，未得到控制的糖尿病患者的高钙尿症可能是一种肾性高钙尿症，可能导致甲状旁腺受到刺激，这可能促使糖尿病患者发生骨质减少。
