Aman J, Berne C, Ewald U, Tuvemo T
Department of Pediatrics, University Hospital, Uppsala, Sweden.
Diabetes Care. 1990 Oct;13(10):1029-33. doi: 10.2337/diacare.13.10.1029.
Cutaneous blood flow was measured with the laser Doppler technique and by recording cutaneous O2 tension on the forearm and forehead in nine young adult patients with insulin-dependent diabetes mellitus (IDDM) and nine sex- and age-matched healthy control subjects after induction of hypoglycemia. In the healthy subjects, cutaneous blood flow measured with the laser Doppler technique was increased by 120 +/- 26% in the forehead (P less than 0.01) and 196 +/- 50% in the forearm (P less than 0.01) at the glucose nadir (blood glucose 1.8 +/- 0.2 mM) compared with basal blood flow. In contrast, in diabetic patients, cutaneous blood flow was unchanged. The corresponding changes, at the glucose nadir, with cutaneous O2 tension recordings were 286 +/- 131% (P less than 0.05) in control subjects and -22 +/- 15% (NS) in diabetic patients. An impairment of sympathetic nervous function, not detectable by simple cardiovascular tests, could be responsible for the lack of cutaneous hyperemia and sweating and could contribute to unawareness of hypoglycemia in diabetic patients.
采用激光多普勒技术，并通过记录9名胰岛素依赖型糖尿病（IDDM）年轻成年患者及9名年龄和性别匹配的健康对照者在低血糖诱发后前臂和前额的皮肤氧张力，来测量皮肤血流。在健康受试者中，与基础血流相比，在血糖最低点（血糖1.8±0.2 mM）时，激光多普勒技术测量的前额皮肤血流增加了120±26%（P<0.01），前臂皮肤血流增加了196±50%（P<0.01）。相比之下，糖尿病患者的皮肤血流没有变化。在血糖最低点时，皮肤氧张力记录的相应变化在对照者中为286±131%（P<0.05），在糖尿病患者中为-22±15%（无显著性差异）。交感神经功能受损，通过简单的心血管检查无法检测到，可能是糖尿病患者缺乏皮肤充血和出汗的原因，并且可能导致低血糖无意识。
