Pramming S, Thorsteinsson B, Theilgaard A, Pinner E M, Binder C
Br Med J (Clin Res Ed). 1986 Mar 8;292(6521):647-50. doi: 10.1136/bmj.292.6521.647.
Neuropsychological testing was carried out in 16 insulin dependent (type I) diabetic men during four periods when mean blood glucose concentrations were (A) 6.3 (SEM 0.13) mmol/l (113.5 (SEM 2.3) mg/100 ml), (B) 2.9 (0.05) mmol/l (52.3 (0.9) mg/100 ml), and (C) 1.8 (0.03) mmol/l (32.4 (0.05) mg/100 ml), all measured during intravenous insulin infusion, and (D) 6.1 (0.13) mmol/l (109.9 (2.3) mg/100 ml), measured after intravenous glucose. The total neuropsychological test score decreased between periods A and B, A and C, and B and C, whereas improvement occurred between periods C and D (all p less than 0.02). These results were not due to changes in individual subjects alone but were consistent for the whole group. During hypoglycaemia there were changes in the patients' estimates of elapsed time, which were underestimated at period C as compared with the estimates at periods A, B, and D (all p less than 0.05). None of the 16 patients noticed symptoms of hypoglycaemia at period A or B, 12 reported symptoms at C, and one at D. Patients with type I diabetes may show a deterioration in neuropsychological skills during periods of asymptomatic subnormal or hypoglycaemic blood glucose concentrations.
对16名胰岛素依赖型（I型）糖尿病男性进行了神经心理学测试，测试在四个阶段进行，期间平均血糖浓度分别为：（A）6.3（标准误0.13）毫摩尔/升（113.5（标准误2.3）毫克/100毫升），（B）2.9（0.05）毫摩尔/升（52.3（0.9）毫克/100毫升），以及（C）1.8（0.03）毫摩尔/升（32.4（0.05）毫克/100毫升），所有这些均在静脉输注胰岛素期间测得，（D）6.1（0.13）毫摩尔/升（109.9（2.3）毫克/100毫升），在静脉输注葡萄糖后测得。神经心理学测试总分在A与B、A与C以及B与C阶段之间下降，而在C与D阶段之间有所改善（所有p值均小于0.02）。这些结果并非仅由个体受试者的变化所致，而是在整个组中保持一致。在低血糖期间，患者对经过时间的估计发生了变化，与A、B和D阶段的估计相比，C阶段的估计被低估（所有p值均小于0.05）。16名患者中没有一人在A或B阶段注意到低血糖症状，12人在C阶段报告有症状，1人在D阶段报告有症状。I型糖尿病患者在无症状性血糖低于正常水平或低血糖期间，神经心理学技能可能会出现恶化。
