Holländer E
III. Abteilung Innere Medizin, Korányi-Krankenhauses Budapest.
Z Gesamte Inn Med. 1989 May 1;44(9):261-4.
For establishing the mode of treatment 55 non-insulin-dependent diabetic patients with later sulfonylurea resistance were examined with respect to insulin and insulin-sulfonylurea sensitivity. The test is helpful in reducing the time of clinical evaluation, in the easy and rapid selection of the suitable medication. 37 patients with sulfonylurea resistance were also resistant to insulin. In 21 of them the combined insulin and sulfonylurea test showed a significant fall of blood sugar. The latter received combined insulin and sulfonylurea therapy for 5 years. During this observation period treatment proved to be effective, the fasting, postprandial and daily values of blood sugar, glycosuria and HbA1 concentrations showed constant decrease. With the combined insulin and sulfonylurea therapy and low insulin doses carbohydrate metabolism may be normalized. In 2/3 of patients repeated daily injection of insulin was not required. Severe hypoglycemia did not occur in the course of treatment.
为确定治疗方式,对55例后期出现磺脲类药物抵抗的非胰岛素依赖型糖尿病患者进行了胰岛素及胰岛素-磺脲类药物敏感性检查。该检查有助于缩短临床评估时间,便于快速选择合适的药物。37例对磺脲类药物抵抗的患者对胰岛素也有抵抗。其中21例联合胰岛素和磺脲类药物试验显示血糖显著下降。后者接受联合胰岛素和磺脲类药物治疗5年。在该观察期内,治疗被证明是有效的,空腹、餐后及每日血糖值、糖尿和糖化血红蛋白浓度均持续下降。采用联合胰岛素和磺脲类药物治疗且胰岛素剂量较低时,碳水化合物代谢可恢复正常。2/3的患者无需每日重复注射胰岛素。治疗过程中未发生严重低血糖。