Dandona P, Fonseca V, Fernando O, Menon R K, Weerakoon J, Kurtz A, Stephen R
Diabetes Res. 1987 May;5(1):47-9.
In 2 patients with insulin dependent diabetes and resistance to subcutaneously injected insulin, adequate glucose homeostasis was achieved following the administration of insulin through a subcutaneous peritoneal access device (SPAD). Fasting and post-prandial plasma glucose concentrations fell to near normal levels and HbA1 fell from 17.8% to 9% and from 15.4% to 8% respectively. Insulin requirements fell from 3,000 and 8,000 units to 160 and 100 units per day, respectively. Measurements of sequential free insulin concentrations in serum following subcutaneous and intraperitoneal insulin injection (100 i.u.) showed a significant increase in serum free insulin following intraperitoneal injection, but none after subcutaneous injection. Glucose concentrations fell after intraperitoneal injection of insulin, but not after subcutaneous injection. It is concluded that: intraperitoneal insulin administration is an effective alternative to subcutaneous injections of insulin in patients with this form of insulin resistance; and in patients with this form of insulin resistance, subcutaneous injections of insulin are not followed by an increase in serum free insulin.
在2例胰岛素依赖型糖尿病且对皮下注射胰岛素耐药的患者中，通过皮下-腹腔通路装置（SPAD）给予胰岛素后，实现了充分的血糖稳态。空腹和餐后血浆葡萄糖浓度降至接近正常水平，糖化血红蛋白（HbA1）分别从17.8%降至9%，从15.4%降至8%。胰岛素需求量分别从每日3000单位和8000单位降至160单位和100单位。皮下和腹腔注射胰岛素（100国际单位）后，连续测定血清中游离胰岛素浓度显示，腹腔注射后血清游离胰岛素显著增加，而皮下注射后无增加。腹腔注射胰岛素后血糖浓度下降，但皮下注射后未下降。结论是：对于这种形式的胰岛素抵抗患者，腹腔内胰岛素给药是皮下注射胰岛素的有效替代方法；对于这种形式的胰岛素抵抗患者，皮下注射胰岛素后血清游离胰岛素不会增加。
