Rett K, Wicklmayr M, Schwiegelshohn B, Mickan C, Dietze G, Mehnert H
Dtsch Med Wochenschr. 1986 May 16;111(20):780-4. doi: 10.1055/s-2008-1068531.
Twelve metabolically normal subjects were given 0.325 g/kg fructose or glucose dissolved in water 30 minutes after intravenous infusion of insulin, 0.05 U/kg. Blood glucose concentration was then measured for up to 60 minutes or until the onset of hypoglycaemia (study I). In study II two bread units (BU) were given to six subjects in the form of dark bread, as well as 12 g of butter and water. In two other groups, of six subjects each, 1 BU was substituted either by fructose or sorbitol. Seven subjects who had been given insulin but only water to drink afterwards served as the control group. In study I, both glucose and fructose achieved a clear slowing in the blood-sugar drop compared with the control group. But with glucose there was initially a slight rerise and the final hypoglycaemic level was somewhat delayed. This minor difference between glucose and fructose was not demonstrable in study II with the addition of fat and carbohydrate substitution. Each carbohydrate combination similarly influenced the course of blood sugar concentration. The results indicate that diabetics should continue to be given glucose rather than fructose or sorbitol if hypoglycaemia occurs. On the other hand, both fructose and sorbitol, although acutely less effective in raising blood glucose concentration, do counteract as carbohydrates the development of insulin-induced hypoglycaemia.
12名代谢正常的受试者在静脉输注0.05 U/kg胰岛素30分钟后，分别给予溶解于水中的0.325 g/kg果糖或葡萄糖。随后测量血糖浓度，持续60分钟或直至低血糖发作（研究I）。在研究II中，给6名受试者给予两个面包单位（BU）的黑面包，以及12 g黄油和水。在另外两组中，每组6名受试者，将1个BU分别用果糖或山梨醇替代。7名接受胰岛素但之后只喝水的受试者作为对照组。在研究I中，与对照组相比，葡萄糖和果糖均使血糖下降明显减缓。但葡萄糖最初有轻微回升，最终低血糖水平有所延迟。在添加脂肪和碳水化合物替代的研究II中，葡萄糖和果糖之间的这种微小差异并不明显。每种碳水化合物组合对血糖浓度变化过程的影响相似。结果表明，如果发生低血糖，糖尿病患者仍应给予葡萄糖而非果糖或山梨醇。另一方面，尽管果糖和山梨醇在急性升高血糖浓度方面效果较差，但作为碳水化合物确实能抵消胰岛素诱导的低血糖的发展。
