Montaña E, Fernández-Castañer M, Rosel P, Gómez J M, Vinzia C, Soler J
Endocrinology Unit Hospital de Bellvitge L'Hopitalet de Llobregat Barcelona, Spain.
Diabete Metab. 1990 May-Jun;16(3):220-5.
To evaluate the influence of insulin antibodies (IA) on metabolic deterioration after interruption of continuous subcutaneous insulin infusion (CSII), we studied two groups of type I diabetic patients without residual insulin secretion: group 1 (5 patients) with insulin-binding antibodies below 10% and group 2 (8 patients) with insulin-binding antibodies above 10%. We investigated the changes in blood glucose, plasma non-esterified fatty acids (NEFA), bicarbonate and glucagon after stopping insulin infusion between 08.00 h. and 14.00 h. Insulin infusion cessation resulted in: 1) a similar increase in blood glucose in both groups after 2 hours of interruption (group 1: 9.45 +/- 1.28 mmol/L versus basal levels of 6.94 +/- 0.96 mmol/L, p less than 0.05; group 2: 8.11 +/- 2.87 mmol/L versus 5.75 +/- 2.17 mmol/L, p less than 0.02) and a greater increase in blood glucose in group 1 than group 2 after 4 hours (p less than 0.05) and after 6 hours (p less than 0.05); 2) a progressive increase in NEFA in group 1 throughout the study period (08.00 h.: 0.51 +/- 0.28 mmol/L; 14.00 h: 1.44 +/- 0.45 mmol/L, p less than 0.05) that was significant after 4 and 6 hours of CSII interruption; there were no changes in NEFA in group 2; 3) plasma level of IA correlated inversely with final glycemia (r = -0.67, p less than 0.01) and final NEFA (r = -0.56, p = 0.02). We conclude that IA may play a role in slowing metabolic deterioration after CSII interruption.
为评估胰岛素抗体（IA）对持续皮下胰岛素输注（CSII）中断后代谢恶化的影响，我们研究了两组无残余胰岛素分泌的I型糖尿病患者：第1组（5例患者）胰岛素结合抗体低于10%，第2组（8例患者）胰岛素结合抗体高于10%。我们调查了08:00至14:00停止胰岛素输注后血糖、血浆非酯化脂肪酸（NEFA）、碳酸氢盐和胰高血糖素的变化。停止胰岛素输注导致：1）两组中断2小时后血糖均有相似程度升高（第1组：9.45±1.28 mmol/L，基础水平为6.94±0.96 mmol/L，p<0.05；第2组：8.11±2.87 mmol/L，基础水平为5.75±2.17 mmol/L，p<0.02），且第1组在4小时（p<0.05）和6小时（p<0.05）后血糖升高幅度大于第2组；2）第1组在整个研究期间NEFA逐渐升高（08:00时：0.51±0.28 mmol/L；14:00时：1.44±0.45 mmol/L，p<0.05），在CSII中断4小时和6小时后升高显著；第2组NEFA无变化；3）IA的血浆水平与最终血糖（r = -0.67，p<0.01）和最终NEFA（r = -0.56，p = 0.02）呈负相关。我们得出结论，IA可能在减缓CSII中断后的代谢恶化中起作用。
