Bolli G, Calabrese G, De Feo P, Compagnucci P, Zega G, Angeletti G, Cartechini M G, Santeusanio F, Brunetti P
Diabetologia. 1982 Feb;22(2):100-5. doi: 10.1007/BF00254837.
Mild hypoglycaemia was induced using an artificial pancreas in five normal subjects (from 5.00 +/- 0.15 to 2.83 +/- 0.15 mmol/l) by infusing 28 mU/m2 per min soluble insulin for 60 min. Six Type 1 (insulin-dependent) diabetic patients were stabilized for 14h using an artificial pancreas. They were then rendered hypoglycaemic (from 4.94 +/- 0.09 to 2.89 +/- 0.11 mmol/l) by infusing 28 mU/m2 per min plus 16 +/- 3.8 mU/min insulin for 60 min. Before the study, the diabetic patients were in optimal blood glucose control (mean blood glucose 6.72 +/- 0.11 mmol/l over the previous 14-20 days; HbA1 8.3 +/- 0.1%). During the insulin infusion test, blood glucose decrement was slower in the diabetic patients than in the control subjects. The blood glucose nadir was delayed in the diabetics until 75 min compared with 55 min in the control subjects. Blood glucose recovery rate in the diabetic subjects was severely impaired. In Type 1 diabetes, the counter-regulatory hormonal response to insulin induced hypoglycaemia is similar to that of non-diabetics, except for that of glucagon, the blunted response of which is not reversed by prolonged optimisation of blood glucose control. This impaired response of the A cell does not seem to be a consequence of insulin deficiency.
在5名正常受试者中，通过以每分钟28 mU/m²的速率输注可溶性胰岛素60分钟，使用人工胰腺诱导轻度低血糖（血糖从5.00±0.15 mmol/l降至2.83±0.15 mmol/l）。6名1型（胰岛素依赖型）糖尿病患者使用人工胰腺稳定血糖14小时。然后，通过以每分钟28 mU/m²加16±3.8 mU/分钟的速率输注胰岛素60分钟，使他们出现低血糖（血糖从4.94±0.09 mmol/l降至2.89±0.11 mmol/l）。在研究前，糖尿病患者的血糖控制处于最佳状态（在过去14 - 20天内平均血糖为6.72±0.11 mmol/l；糖化血红蛋白为8.3±0.1%）。在胰岛素输注试验期间，糖尿病患者的血糖下降速度比对照组慢。糖尿病患者的血糖最低点延迟至75分钟，而对照组为55分钟。糖尿病患者的血糖恢复率严重受损。在1型糖尿病中，对胰岛素诱导的低血糖的反调节激素反应与非糖尿病患者相似，除了胰高血糖素，其反应迟钝，即使通过长期优化血糖控制也不会逆转。A细胞的这种受损反应似乎不是胰岛素缺乏的结果。
