Hidaka H, Furusawa S, Kosugi K, Harano Y, Shigeta Y
Horm Metab Res. 1987 Mar;19(3):122-4. doi: 10.1055/s-2007-1011756.
To investigate whether correction of fasting hyperglycemia per se improves the insulin secretion in type 2 diabetic subjects, plasma insulin response to 75 g oral glucose load has been studied after acute and chronic normalization of fasting plasma glucose levels in 7 overt type 2 diabetic subjects. For the acute normalization of elevated fasting plasma glucose levels, an artificial endocrine pancreas was employed. Although fasting plasma glucose concentrations were normalized before the oral glucose challenge, insulin response to oral glucose was not improved compared to those without normalization of fasting plasma glucose levels. After 1-3 month control of hyperglycemia, the insulin response to glucose in the subjects was significantly improved compared to those without treatments. Results indicate that chronic metabolic control is essential for the improvement of insulin response to glucose in type 2 diabetic subjects, and also suggest that the impaired insulin secretion in type 2 diabetes is not due to hyperglycemia per se, but due to the metabolic derangements which lead to chronic hyperglycemia.
为研究单纯纠正空腹高血糖是否能改善2型糖尿病患者的胰岛素分泌，我们对7例显性2型糖尿病患者在空腹血糖水平急性和慢性正常化后，口服75g葡萄糖负荷时的血浆胰岛素反应进行了研究。为使升高的空腹血糖水平急性正常化，采用了人工内分泌胰腺。尽管在口服葡萄糖激发试验前空腹血糖浓度已正常化，但与空腹血糖水平未正常化的患者相比，口服葡萄糖的胰岛素反应并未改善。在控制高血糖1 - 3个月后，与未治疗的患者相比，这些患者对葡萄糖的胰岛素反应显著改善。结果表明，慢性代谢控制对于改善2型糖尿病患者对葡萄糖的胰岛素反应至关重要，也提示2型糖尿病患者胰岛素分泌受损并非由于高血糖本身，而是由于导致慢性高血糖的代谢紊乱。
