Dornan T L, Peckar C O, Mayon-White V A, Knight A H, Moore R A, Hockaday T D, Bron A J, Turner R C
Q J Med. 1981;50(197):31-8.
Control of diabetes in a group of 82 insulin-treated diabetics was assessed by in-patient 24-hour plasma glucose profiles and haemoglobin A1 (HbA1) estimation. Thirty-two of these patients (39 per cent) had hypoglycaemia (plasma glucose less than or equal to 2 mmol/l) which was rarely associated with symptoms. Twenty-seven (61 per cent) of 44 patients who took a series of out-patient pre-prandial capillary blood samples over a three-day period had hypoglycaemia. Conventional measurements of diabetic control including fasting plasma glucose and HbA1, were lower in patients with hypoglycaemia than in those without. Rebound hyperglycaemia following hypoglycaemia was not seen and its absence was not due to diabetic autonomic neuropathy. Cortisol/creatinine ratios in early morning urine samples were similar in patients with and without nocturnal hypoglycaemia, consistent with the absence or rebound hyperglycaemia. Diabetic retinopathy was less prevalent in patients with hypoglycaemia, possibly reflecting better long-term diabetic control in this group. HbA1 concentration reflects overall blood glucose control in diabetes but near-normal levels must be interpreted with caution since they may be associated with recurrent hypoglycaemia.
通过住院患者24小时血浆葡萄糖谱和血红蛋白A1（HbA1）测定，评估了一组82名接受胰岛素治疗的糖尿病患者的糖尿病控制情况。这些患者中有32名（39%）发生了低血糖（血浆葡萄糖小于或等于2 mmol/L），且很少伴有症状。在44名在三天时间内采集了一系列门诊餐前毛细血管血样本的患者中，有27名（61%）发生了低血糖。低血糖患者的糖尿病控制常规测量指标，包括空腹血浆葡萄糖和HbA1，低于无低血糖的患者。低血糖后未出现反弹性高血糖，且未出现并非由于糖尿病自主神经病变。有夜间低血糖和无夜间低血糖患者的清晨尿样中皮质醇/肌酐比值相似，这与未出现或无反弹性高血糖一致。低血糖患者的糖尿病视网膜病变患病率较低，这可能反映出该组患者长期糖尿病控制较好。HbA1浓度反映糖尿病患者的总体血糖控制情况，但接近正常水平时必须谨慎解读，因为它们可能与反复低血糖有关。
