Kollind M, Adamson U, Lins P E
Department of Internal Medicine, Danderyd Hospital, Stockholm, Sweden.
Acta Endocrinol (Copenh). 1987 Nov;116(3):314-20. doi: 10.1530/acta.0.1160314.
Glucose metabolism was studied by a somatostatin-insulin-glucose infusion test (SIGIT) for 8 h in 7 male patients with insulin-dependent diabetes mellitus. They were investigated on two occasions in random order, with and without preceding hypoglycaemia induced between 3.00 and 4.00 h. SIGIT was started at 7.00 h when blood glucose was restored to normal and the counterregulatory hormones had returned to basal values. As expected, hypoglycaemia evoked an enhancement of the plasma levels of GH (43.7 +/- 10.1 vs 4.4 +/- 1.8 micrograms/l), cortisol (690 +/- 59 vs 140 +/- 32 nmol/l), glucagon (225 +/- 35 vs 143 +/- 25 ng/l), and epinephrine (3.80 +/- 1.00 vs 0.10 +/- 0.03 nmol/l). During the SIGIT, the levels of circulating free insulin and counterregulatory hormones were similar in the two tests notwithstanding that excessive hyperglycaemia appeared when SIGIT was preceded by hypoglycaemia. The present study thus demonstrates that nocturnal hypoglycaemia induces insulin resistance in insulin-dependent diabetic patients not deprived of insulin.
对7名胰岛素依赖型糖尿病男性患者进行了8小时的生长抑素-胰岛素-葡萄糖输注试验（SIGIT）以研究葡萄糖代谢。他们按随机顺序在两种情况下接受调查，一种是在3:00至4:00之间诱导低血糖之前，另一种是在没有诱导低血糖的情况下。当血糖恢复正常且反调节激素恢复到基础值时，于7:00开始SIGIT。正如预期的那样，低血糖引起生长激素（43.7±10.1对4.4±1.8微克/升）、皮质醇（690±59对140±32纳摩尔/升）、胰高血糖素（225±35对143±25纳克/升）和肾上腺素（3.80±1.00对0.10±0.03纳摩尔/升）血浆水平升高。在SIGIT期间，尽管在SIGIT之前出现低血糖时会出现过度高血糖，但两次试验中循环游离胰岛素和反调节激素的水平相似。因此，本研究表明夜间低血糖会在未停用胰岛素的胰岛素依赖型糖尿病患者中诱导胰岛素抵抗。
