Aman J, Wranne L
Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Acta Paediatr Scand. 1988 Jul;77(4):542-7. doi: 10.1111/j.1651-2227.1988.tb10697.x.
Hypoglycaemia (blood glucose 1.3-2.5 mmol/l) was induced in twenty-eight diabetic children by reduction of their morning meal. Fatigue and pallor were the most common signs of hypoglycaemia. Compared to findings during normoglycaemia, plasma concentrations of adrenalin, noradrenalin and cortisol were significantly higher at glucose nadir. Plasma glucagon concentration at glucose nadir was correlated to the fasting C-peptide concentration and inversely to the duration of diabetes. Children who lacked C-peptide also lacked glucagon response to hypoglycaemia. The parents' opinion of the need to give carbohydrates corresponded to the blood glucose level. The presence of adrenergic signs correlated to the plasma adrenalin and the neuroglucopenic signs to blood glucose. The lowest glucose level correlated inversely to the concentration of free insulin. When facilities for glucose infusion are lacking, a rational step in treating the unconscious hypoglycaemic child seems to be the injection of glucagon, considering the blunted or absent glucagon secretion.
通过减少早餐量，在28名糖尿病儿童中诱发低血糖（血糖1.3 - 2.5 mmol/l）。疲劳和面色苍白是低血糖最常见的体征。与血糖正常期间的结果相比，在血糖最低点时，血浆肾上腺素、去甲肾上腺素和皮质醇浓度显著升高。血糖最低点时的血浆胰高血糖素浓度与空腹C肽浓度相关，与糖尿病病程呈负相关。缺乏C肽的儿童对低血糖也缺乏胰高血糖素反应。家长对给予碳水化合物必要性的看法与血糖水平相符。肾上腺素能体征的出现与血浆肾上腺素相关，而神经低血糖体征与血糖相关。最低血糖水平与游离胰岛素浓度呈负相关。当缺乏葡萄糖输注设备时，考虑到胰高血糖素分泌减弱或缺乏，对于昏迷的低血糖儿童，合理的治疗措施似乎是注射胰高血糖素。
