Shen S W, Reaven G M, Farquhar J W
J Clin Invest. 1970 Dec;49(12):2151-60. doi: 10.1172/JCI106433.
A technique was devised for a more accurate measurement than has been heretofore possible of one of the factors responsible for hyperglycemia in the complex syndrome of diabetes. This factor is termed impedance and represents the tissues' insensitivity or resistance to insulin-mediated glucose uptake. It was measured by use of steady-state exogenous insulin and glucose infusions during a period of pharmacological suppression of endogenous insulin secretion. Endogenous new glucose production was also inhibited. Impedance as calculated is a direct function of steady-state glucose concentrations, since exogenous insulin concentrations were similar in all studies. Two groups of normal weight subjects were studied. One had maturity onset latent diabetes, and the other (matched for age, weight, and per cent adiposity) was normal. Impedance was closely reproducible in the same individual and remained relatively constant during prolonged infusions. The diabetics had average infusion glucose concentrations (and thus impedance) 68% higher than the normal group, and it is of note that their previously measured glucose intolerance differed by a similar degree; that is, the diabetic's intolerance (as defined by mean weighted plasma glucose response after oral glucose) was 52% greater than that of the normal individuals.
人们设计了一种技术，用于比以往更精确地测量糖尿病复杂综合征中导致高血糖的一个因素。这个因素被称为阻抗，它代表组织对胰岛素介导的葡萄糖摄取的不敏感性或抵抗性。通过在对内源性胰岛素分泌进行药理抑制的期间使用稳态外源性胰岛素和葡萄糖输注来测量它。内源性新葡萄糖生成也受到抑制。由于在所有研究中外源性胰岛素浓度相似，所以计算得出的阻抗是稳态葡萄糖浓度的直接函数。研究了两组正常体重的受试者。一组患有成年发病型潜伏性糖尿病，另一组（在年龄、体重和肥胖百分比方面匹配）是正常的。阻抗在同一个体中具有高度可重复性，并且在长时间输注期间保持相对恒定。糖尿病患者的平均输注葡萄糖浓度（以及因此的阻抗）比正常组高68%，值得注意的是，他们之前测量的葡萄糖耐量差异程度相似；也就是说，糖尿病患者的不耐受性（由口服葡萄糖后平均加权血浆葡萄糖反应定义）比正常个体高52%。
