Mokuda O, Murakami I, Ikeda T, Tominaga M, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
Exp Clin Endocrinol. 1988 Aug;91(3):265-70. doi: 10.1055/s-0029-1210757.
To estimate the residual beta-cell function, plasma glucose and C-peptide response to an intravenous injection of tolbutamide were observed in seven Type I (insulin dependent) and nine Type II (non-insulin dependent) diabetic patients on insulin therapy. Fasting plasma glucose in the patient was controlled below 11 mmol/l by conventional insulin therapy, and 1 g of tolbutamide was intravenously injected. In the serum C-peptide response following tolbutamide injection, seven of nine Type II diabetics showed the peak values of serum C-peptide more than 0.3 nmol/l from 20 min to 60 min after the load, and Type I diabetics gained the peak values less than 0.3 nmol/l except one patient. The decrease of plasma glucose within 60 min after tolbutamide injection was more than 20% of the basal level in eight of nine Type II diabetics, and in all of seven Type I diabetics the decrease did not exceed 15%. Both serum C-peptide and plasma glucose after tolbutamide load responded differently between Type I and Type II diabetics on insulin therapy, and it was thought that tolbutamide load-glucose response test may be a useful method to estimate the residual beta-cell function in the diabetics.
为评估残余β细胞功能，对7例I型（胰岛素依赖型）和9例II型（非胰岛素依赖型）接受胰岛素治疗的糖尿病患者，观察了静脉注射甲苯磺丁脲后的血浆葡萄糖和C肽反应。通过常规胰岛素治疗，患者的空腹血浆葡萄糖被控制在11 mmol/l以下，然后静脉注射1 g甲苯磺丁脲。在甲苯磺丁脲注射后的血清C肽反应中，9例II型糖尿病患者中有7例在负荷后20分钟至60分钟血清C肽峰值超过0.3 nmol/l，而I型糖尿病患者除1例患者外，峰值均低于0.3 nmol/l。9例II型糖尿病患者中有8例在甲苯磺丁脲注射后60分钟内血浆葡萄糖下降超过基础水平的20%，而7例I型糖尿病患者血浆葡萄糖下降均未超过15%。在接受胰岛素治疗的I型和II型糖尿病患者中，甲苯磺丁脲负荷后血清C肽和血浆葡萄糖的反应不同，认为甲苯磺丁脲负荷-葡萄糖反应试验可能是评估糖尿病患者残余β细胞功能的一种有用方法。
