Ternand C, Go V L, Gerich J E, Haymond M W
J Pediatr. 1982 Jul;101(1):36-9. doi: 10.1016/s0022-3476(82)80176-5.
The increased incidence of severe hypoglycemia reported in young children with diabetes is consistent with a defect in glucagon secretion or a generalized abnormality in islet hormone secretion. To assess pancreatic hormone and gastric inhibitory polypeptide secretion in children with early onset diabetes, 12 children with onset of diabetes prior to the age of 28 months were studied and the data compared to the hormone responses observed in 11 children with LOD, diagnosed after the age of 5 years. Plasma glucose, C-peptide, glucagon, pancreatic polypeptide, and gastric inhibitory peptide concentrations were measured during and following an arginine infusion (500 mg/kg over 60 minutes) and a mixed meal. During arginine infusion, plasma glucose and glucagon increased similarly in both groups and returned to basal concentrations following discontinuation of arginine infusion. In contrast, plasma C-peptide, hPP, and GIP concentrations did not change. Following the mixed meal plasma glucose, hPP, and GIP concentrations increased similarly in the two groups of children, but no change was observed in either plasma glucagon or C-peptide concentrations in either group. These data demonstrate that EOD and LOD are associated with insulin insufficiency alone and that abnormalities in secretion of other pancreatic islet hormone or GIP cannot be implicated in the high incidence of severe hypoglycemia observed in children with EOD.
糖尿病幼儿中报告的严重低血糖发病率增加与胰高血糖素分泌缺陷或胰岛激素分泌的普遍异常一致。为了评估早发性糖尿病儿童的胰腺激素和胃抑制性多肽分泌情况，研究了12名糖尿病发病年龄在28个月之前的儿童，并将数据与11名5岁后诊断为迟发性糖尿病（LOD）的儿童的激素反应进行比较。在精氨酸输注（60分钟内500mg/kg）和混合餐后，测量血浆葡萄糖、C肽、胰高血糖素、胰多肽和胃抑制肽浓度。在精氨酸输注期间，两组血浆葡萄糖和胰高血糖素的增加相似，精氨酸输注停止后恢复到基础浓度。相反，血浆C肽、人胰多肽（hPP）和胃抑制肽（GIP）浓度没有变化。混合餐后，两组儿童的血浆葡萄糖、hPP和GIP浓度增加相似，但两组的血浆胰高血糖素或C肽浓度均未观察到变化。这些数据表明，早发性糖尿病（EOD）和迟发性糖尿病仅与胰岛素不足有关，并且在早发性糖尿病儿童中观察到的严重低血糖高发病率不能归因于其他胰岛激素或GIP分泌异常。
