Válek J, Vlasáková Z, Pelikánová J, Karasová I, Jirkovská A, Grafnetter D
Institut klinické a experimentálni medicíny, Praha.
Vnitr Lek. 1990 Feb;36(2):154-62.
Based on an analysis of data obtained in a group of 145 men and women with type 2 diabetes perssiting for 10.1 +/- 6.6 years who were hospitalized on account of unsatisfactory compensation of diabetes, the authors provided evidence that the fasting blood sugar level is associated with a reduced response of C peptide to an alimentary stimulus, while the excessive weight of the patients has a bearing on the elevated concentration of C peptide on fasting and causes their insulin resistance. The body weight has a bearing on the level of risk factors, i.e. HDL cholesterol, uric acid and in women also triacylglycerols. The elevated blood sugar level influences in a mirror image manner the sodium and potassium level. The relations between the blood sugar level and glomerular filtration draw attention to the interference with the water economy even at blood sugar levels which are still tolerated. The trend of rising potassium levels must be foreseen in case of a poor compensation even in case of insulin treatment of diabetes. The risk of elevated potassium should be taken into account also with regard to indications of antihypertensive treatment. The authors also draw attention to the need of acloser compensation of type 2 diabetes. Early adjustment of the energy metabolism in diabetics deserves priority. When insulin treatment is needed, the all-day requirement should be met by 2-3 doses.
基于对一组145名2型糖尿病患者（病程为10.1±6.6年）的数据分析，这些患者因糖尿病控制不佳而住院，作者提供了证据表明，空腹血糖水平与C肽对进食刺激的反应降低有关，而患者的超重与空腹时C肽浓度升高有关，并导致他们的胰岛素抵抗。体重与危险因素水平有关，即高密度脂蛋白胆固醇、尿酸，对女性而言还与甘油三酯有关。血糖水平升高以镜像方式影响钠和钾水平。血糖水平与肾小球滤过之间的关系表明，即使在仍可耐受的血糖水平下，也会干扰水代谢。即使在糖尿病胰岛素治疗的情况下，若病情控制不佳，也必须预见到钾水平上升的趋势。在考虑抗高血压治疗指征时，也应考虑高钾风险。作者还提请注意更严格控制2型糖尿病的必要性。糖尿病患者能量代谢的早期调整应优先进行。当需要胰岛素治疗时，全天剂量应分2 - 3次给予。
