Aman J, Wranne L
Department of Paediatrics, Orebro Medical Centre Hospital, Sweden.
Acta Paediatr Scand. 1988 Jul;77(4):548-53. doi: 10.1111/j.1651-2227.1988.tb10698.x.
Hypoglycaemia (blood glucose 1.3-2.5 mmol/l) was induced in thirty diabetic children by reduction of their morning meal. Glucagon, 10 or 20 micrograms/kg was then given by intramuscular or subcutaneous injection. Ten min later, all signs of hypoglycaemia had disappeared and blood glucose concentrations increased by 0.7-3.3 mmol/l. Glucagon plasma concentrations at glucose nadir were low, 23 +/- 8 pmol/l, rose to 300 +/- 42 ten min after the injection and reached peak values after another ten min. Later, a slow decrease was noted. No significant difference of blood glucose or plasma glucagon concentrations were found after subcutaneous or intramuscular injections of 20 micrograms/kg. After 10 micrograms/kg, slightly lower increase of blood glucose was seen, but the clinical effect was equally good. Nausea occurred in four children given 20 micrograms/kg. The rise of blood glucose did not correlate to the peak glucagon concentration obtained after the injection but showed significant correlations to the lowest glucose concentration and, inversely, to the concentration of free insulin in blood at glucose nadir. It is concluded that glucagon injections are effective in hypoglycaemia in insulin-treated diabetic children and that the injection of 10-20 micrograms/kg gives long-standing supraphysiological concentrations which make repeated injections unnecessary.
通过减少早餐量，在30名糖尿病儿童中诱发低血糖（血糖1.3 - 2.5 mmol/l）。然后通过肌肉注射或皮下注射给予胰高血糖素，剂量为10或20微克/千克。10分钟后，所有低血糖症状消失，血糖浓度升高0.7 - 3.3 mmol/l。血糖最低点时的胰高血糖素血浆浓度较低，为23±8 pmol/l，注射后10分钟升至300±42，再过10分钟达到峰值。随后，观察到缓慢下降。皮下或肌肉注射20微克/千克后，血糖或血浆胰高血糖素浓度无显著差异。给予10微克/千克后，血糖升高略低，但临床效果同样良好。接受20微克/千克的4名儿童出现恶心。血糖升高与注射后获得的胰高血糖素峰值浓度无关，但与最低血糖浓度显著相关，反之，与血糖最低点时血液中的游离胰岛素浓度相关。结论是，胰高血糖素注射对胰岛素治疗的糖尿病儿童低血糖有效，注射10 - 20微克/千克可产生长时间的超生理浓度，无需重复注射。
