伴有胰岛素抵抗的极不稳定型糖尿病

Hyperlabile diabetes accompanied by insulin resistance.

作者信息

Renie A, Hamilton R G, Adkinson N F, Rendell M S

出版信息

Clin Chem. 1981 Aug;27(8):1463-4.

Abstract

It is generally held that high insulin antibody concentrations, by "buffering" abrupt swings in free insulin concentrations after injections of exogenous insulin, tend to stabilize blood glucose variations in diabetic patients. However, we encountered a patient with extremely labile diabetes coexisting with insulin resistance. This patient's injections were switched to pure porcine insulin from his usual mixed bovine/porcine insulin, in an effort to decrease his insulin requirement. This treatment was successful, and, as his insulin dosage decreased, his diabetic lability diminished substantially. His diabetes was eventually considered stabilized on about 22 units of porcine insulin daily. The serial decrease in his insulin antibody concentrations, monitored by use of solid-phase radioimmunoassay, paralleled the disappearance of his diabetic lability as well as the decrease in his insulin requirement.

摘要

一般认为，高胰岛素抗体浓度通过“缓冲”注射外源性胰岛素后游离胰岛素浓度的突然波动，往往有助于稳定糖尿病患者的血糖变化。然而，我们遇到了一位患有极不稳定糖尿病且并存胰岛素抵抗的患者。为了减少他的胰岛素需求量，将该患者的注射用药从常用的牛/猪混合胰岛素换成了纯猪胰岛素。这种治疗方法取得了成功，随着他胰岛素剂量的减少，他糖尿病的不稳定性大幅降低。最终认为他的糖尿病通过每日约22单位的猪胰岛素实现了稳定。通过固相放射免疫测定法监测，他的胰岛素抗体浓度持续下降，这与他糖尿病不稳定性的消失以及胰岛素需求量的减少是平行的。