Rendell M, Slevin D, Meltz G, Simpson J, Barquet A
Ann Intern Med. 1979 Feb;90(2):195-7. doi: 10.7326/0003-4819-90-2-195.
A nonobese patient with maturity-onset diabetes mellitus was hospitalized for treatment of an ulcer on his right foot. During this episode, his diabetic control worsened, and he proved unresponsive to exogenous insulin. Unresponsiveness to insulin persisted after healing of the ulcer. Tolbutamide therapy was then begun and produced a marked reduction in blood sugar levels. Withdrawal of the drug was accompanied by a progressive rise in blood sugar level. Intravenous infusion of regular pork insulin at rates of 45 U/h and single-component pork insulin at rates of 120 U/h had minimal effect on the blood sugar level. High levels of antibody to beef insulin were measured, with lower levels of pork insulin antibodies. C-peptide values were in a normal range before tolbutamide treatment and increased after use of the drug.
一名非肥胖型成年发病型糖尿病患者因右脚溃疡住院治疗。在此期间，他的糖尿病病情恶化，且对外源性胰岛素无反应。溃疡愈合后，对胰岛素的无反应状态仍持续存在。随后开始使用甲苯磺丁脲治疗，血糖水平显著降低。停药后血糖水平逐渐升高。以45U/h的速率静脉输注正规猪胰岛素和以120U/h的速率输注单组分猪胰岛素对血糖水平影响甚微。检测到高水平的抗牛胰岛素抗体，猪胰岛素抗体水平较低。甲苯磺丁脲治疗前C肽值在正常范围内，用药后升高。
