Selz B, Nyffenegger U, Bürgi H
Schweiz Med Wochenschr. 1980 Oct 18;110(42):1534-7.
All 11 maturity-onset diabetics (age 55 to 79 years) switched from oral hypoglycemics to insulin during one year in our department, even though metabolically stable, have been followed up. The main reason for the change was a diminished sense of well-being combined with relatively ill-defined symptoms such as declining physical performance, fatigue, dizziness and pain in the legs. None of the patients was ketoacidotic and the 24-hour glucosuria was less than 15 g, although the average fasting blood sugar was markedly elevated to 296 mg/dl. After 6 months on insulin the 24-hour glucosuria had not changed but the fasting blood sugar had dropped to 183 mg/dl. This was accompanied by an improved sense of well-being (as measured by an analog scale) and by disappearance of the symptoms mentioned above. Even though 9 of the 11 patients were initially reluctant to change to insulin, all 11 were still on this drug after 6 months. The authors recommend broadening the indications for insulin therapy in stable adult-onset diabetics, particular attention being paid to vague symptoms such as fatigue and decreased physical performance.
在我们科室，11名成年起病的糖尿病患者（年龄55至79岁）在1年内从口服降糖药改用胰岛素，尽管他们代谢稳定，但仍接受了随访。改用胰岛素的主要原因是幸福感下降，并伴有一些相对不明确的症状，如身体机能下降、疲劳、头晕和腿部疼痛。尽管平均空腹血糖显著升高至296毫克/分升，但没有患者发生酮症酸中毒，24小时尿糖低于15克。使用胰岛素6个月后，24小时尿糖没有变化，但空腹血糖降至183毫克/分升。这伴随着幸福感的改善（通过模拟量表测量）以及上述症状的消失。尽管11名患者中有9名最初不愿改用胰岛素，但6个月后所有11名患者仍在使用这种药物。作者建议扩大稳定型成年起病糖尿病患者胰岛素治疗的适应症，尤其要关注疲劳和身体机能下降等模糊症状。
