Renner R, Piwernetz K, Hepp K D
Diabeteszentrum, III. Medizinische Abteilung, Klinikum Bogenhausen, München.
Dtsch Med Wochenschr. 1988 Aug 26;113(34):1322-5. doi: 10.1055/s-2008-1067814.
In 15 type I diabetics the mean postprandial rise in blood glucose levels, 90 min after breakfast at about 8 a.m. (the customary time for this meal in hospitals), was 62.2 +/- 34.3 mg/dl, but 90 min after a breakfast which had been put forward by about 1 1/2 hours it was only 2.6 +/- 18.6 mg/dl (P less than 0.001). Seven patients developed hypoglycaemia after the early breakfast, none after the late one. This finding suggests that, to avoid hypoglycaemia after an early breakfast, an additional small meal should be given at about 8:30 a.m. or the insulin content of the morning injection should be changed. The clear connection between the time of the morning insulin injection and the insulin action during the morning explains why, in uninstructed patients who--under their usual daily conditions of starting school or work--are forced to inject insulin early or to eat early, a state of hypoglycaemia may occur.
在15名I型糖尿病患者中，上午8点左右（医院里这顿饭的常规时间）早餐后90分钟血糖水平的餐后平均升高值为62.2±34.3毫克/分升，但早餐时间提前约1个半小时后90分钟，该值仅为2.6±18.6毫克/分升（P<0.001）。7名患者在提前早餐后出现低血糖，而在延迟早餐后无人出现低血糖。这一发现表明，为避免提前早餐后出现低血糖，应在上午8:30左右额外加餐，或者改变早晨注射胰岛素的剂量。早晨胰岛素注射时间与上午胰岛素作用之间的明确关联解释了为什么在未接受指导的患者中，在他们通常上学或上班的日常情况下，被迫提前注射胰岛素或提前进食时，可能会出现低血糖状态。
