Straumann M, Staffelbach O, Sonnenberg G E, Keller U, Berger W
Schweiz Med Wochenschr. 1979 Dec 1;109(46):1816-20.
15 elderly diabetic patients with fasting blood glucose levels above 160 mg/100 ml, without hyperglycemic symptoms and previously treated with oral antidiabetic agents, were put on insulin. The change of treatment regimen was made in the outpatient department. Frequent clinical and laboratory controls were performed and the patients were given full instructions for injection technique and diet. On the insulin regimen a prompt and lasting improvement was observed in the metabolic parameters (blood glucose levels both fasting and after food intake, Hb A1c, serum insulin, glucagon and serum lipid concentrations). The so-called "asymptomatic" patients noticed a marked improvement in their general status and performance. Three months after insulin therapy was started 13 of our 15 patients preferred the insulin treatment to oral agents. However, weight gain and a tendency to hypoglycemia were noticed in less disciplined patients. In addition, considerable time was spent on instruction of the patients. Bearing these factors in mind, insulin therapy in elderly diabetics with so-called "sysmptomatic hyperglycemia" can be regarded as worthwhile.
15名老年糖尿病患者，空腹血糖水平高于160mg/100ml，无高血糖症状，此前接受口服降糖药治疗，现开始使用胰岛素治疗。治疗方案的调整在门诊进行。定期进行临床和实验室检查，并对患者进行注射技术和饮食方面的详细指导。采用胰岛素治疗后，代谢参数（空腹及餐后血糖水平、糖化血红蛋白、血清胰岛素、胰高血糖素和血脂浓度）迅速且持续改善。这些所谓的“无症状”患者的总体状况和身体机能也有明显改善。胰岛素治疗开始三个月后，15名患者中有13名更倾向于使用胰岛素而非口服药物。然而，在自律性较差的患者中出现了体重增加和低血糖倾向。此外，对患者的指导花费了大量时间。考虑到这些因素，对于患有所谓“无症状高血糖”的老年糖尿病患者，胰岛素治疗是值得的。
