Collier A, Steedman D J, Patrick A W, Nimmo G R, Matthews D M, MacIntyre C C, Little K, Clarke B F
Diabetic and Dietetic Department, Royal Infirmary, Edinburgh, United Kingdom.
Diabetes Care. 1987 Nov-Dec;10(6):712-5. doi: 10.2337/diacare.10.6.712.
Hypoglycemia is a serious problem in insulin-treated diabetic patients. In this study the efficacy of intravenous glucagon (1 mg) was compared with that of intravenous dextrose (25 g) in the treatment of hypoglycemia in insulin-treated patients attending an accident and emergency department. In addition, the prevailing glycemic control of these patients was compared with patients routinely attending a diabetic outpatient clinic. Both intravenous glucagon and dextrose were effective in the treatment of hypoglycemic coma. There was a difference in the glycemic profile after intravenous glucagon compared with intravenous dextrose, and recovery of a normal level of consciousness after glucagon was slower than after dextrose (6.5 vs. 4.0 min, respectively; P less than .001), although the average duration of hypoglycemic coma was 1.4 h. The glucagon- and dextrose-treated groups had significantly lower HbA1 than comparable patients routinely attending the clinic (9.5 +/- 0.8 vs. 12.0 +/- 3.8%, respectively; P less than .001). In view of the ease of administration and the small risk of vascular and extravascular complications, intravenous glucagon appears to be a useful alternative to intravenous dextrose in the treatment of severe hypoglycemia.
低血糖是胰岛素治疗的糖尿病患者的一个严重问题。在本研究中，对静脉注射胰高血糖素（1毫克）与静脉注射葡萄糖（25克）治疗就诊于急诊科的接受胰岛素治疗患者低血糖的疗效进行了比较。此外，将这些患者的血糖控制情况与常规就诊于糖尿病门诊的患者进行了比较。静脉注射胰高血糖素和葡萄糖对低血糖昏迷均有效。与静脉注射葡萄糖相比，静脉注射胰高血糖素后的血糖情况存在差异，且胰高血糖素治疗后意识恢复正常水平的速度比葡萄糖慢（分别为6.5分钟和4.0分钟；P<0.001），尽管低血糖昏迷的平均持续时间为1.4小时。接受胰高血糖素和葡萄糖治疗的组的糖化血红蛋白水平显著低于常规就诊于门诊的可比患者（分别为9.5±0.8%和12.0±3.8%；P<0.001）。鉴于给药方便以及血管和血管外并发症风险小，静脉注射胰高血糖素似乎是治疗严重低血糖时静脉注射葡萄糖的一个有用替代方法。
