Boden G, Soriano M, Hoeldtke R D, Owen O E
Diabetes. 1983 Nov;32(11):1055-9. doi: 10.2337/diab.32.11.1055.
An increasing number of patients with non-insulin-dependent diabetes mellitus (NIDDM) is presently being treated with insulin, some aggressively with intensified treatment schedules. However, there is little information on the ability of these patients to recover from insulin-induced hypoglycemia. We have, therefore, determined glucose recovery and counterregulatory hormone secretion in response to insulin-induced hypoglycemia in 10 NIDDM patients without autonomic neuropathy and in 6 age- and weight-matched normal controls. Recovery of plasma glucose concentration and hypoglycemia-induced increments of plasma concentrations of glucagon, epinephrine, norepinephrine, and HGH were similar in the NIDDM patients and the age- and weight-matched nondiabetic controls. It appears likely, therefore, that these NIDDM patients, if treated aggressively with insulin, may be at lesser risk for severe and prolonged hypoglycemia than insulin-dependent diabetic patients, particularly those with autonomic neuropathy or those treated with beta-adrenergic antagonists.
目前，越来越多的非胰岛素依赖型糖尿病（NIDDM）患者正在接受胰岛素治疗，有些患者采用强化治疗方案积极治疗。然而，关于这些患者从胰岛素诱导的低血糖中恢复的能力，相关信息却很少。因此，我们测定了10名无自主神经病变的NIDDM患者以及6名年龄和体重匹配的正常对照者在胰岛素诱导的低血糖反应中的血糖恢复情况和反调节激素分泌。NIDDM患者与年龄和体重匹配的非糖尿病对照者在血浆葡萄糖浓度的恢复以及低血糖诱导的胰高血糖素、肾上腺素、去甲肾上腺素和生长激素血浆浓度的增加方面相似。因此，这些NIDDM患者如果接受积极的胰岛素治疗，与胰岛素依赖型糖尿病患者相比，尤其是那些有自主神经病变或接受β-肾上腺素能拮抗剂治疗的患者，发生严重和持续性低血糖的风险可能较小。
