Wheatley T, Edwards O M
Diabet Med. 1985 Sep;2(5):400-4. doi: 10.1111/j.1464-5491.1985.tb00663.x.
Three patients with insulin-dependent diabetes mellitus are described in whom generalized oedema and weight gain followed the administration of excessive monocomponent insulins, in two cases associated with symptomatic hypoglycaemia. Serial measurements of plasma volume and transcapillary escape rate of albumin (TERA) using 125I-labelled albumin, serum colloid osmotic pressure (COP) using a membrane colloid osmometer, packed cell volume (PCV), and serum proteins, showed that oedema was associated with an increased plasma volume and TERA, while serum albumin and total protein concentration and serum COP were reduced. A reduction in daily insulin dose abolished hypoglycaemia and resulted in weight loss, natriuresis, diuresis, a reduction in plasma volume and TERA, and an increase in serum albumin, total protein, and COP. Strict metabolic control in previously poorly controlled patients may cause insulin-induced increments in plasma volume and albumin escape rate.
本文描述了3例胰岛素依赖型糖尿病患者，他们在使用过量单组分胰岛素后出现全身水肿和体重增加，其中2例伴有症状性低血糖。使用125I标记白蛋白对血浆容量和白蛋白毛细血管超滤率（TERA）进行连续测量，使用膜胶体渗透压计测量血清胶体渗透压（COP）、红细胞压积（PCV）和血清蛋白，结果显示水肿与血浆容量增加和TERA升高有关，而血清白蛋白、总蛋白浓度和血清COP降低。每日胰岛素剂量减少可消除低血糖，并导致体重减轻、利钠、利尿、血浆容量和TERA降低，以及血清白蛋白、总蛋白和COP升高。在之前控制不佳的患者中进行严格的代谢控制可能会导致胰岛素引起的血浆容量和白蛋白逃逸率增加。
