Sartor G, Scherstén B, Carlström S, Melander A, Nordén A, Persson G
Diabetes. 1980 Jan;29(1):41-9. doi: 10.2337/diab.29.1.41.
In a diabetes detection survey carried out between 1962 and 1965, 2477 (1.1%) of 228,883 subjects had Clinistix-positive glucosuria after a carbohydrate-rich luncheon meal. Of these 2477, 578 displayed impaired tolerance to oral glucose without having manifest diabetes. From this group, 267 men were divided into five groups and subjected to the following treatments and controls: (a) diet regulation and 0.5 g tolbutamide t.i.d. (N = 49), annual oral glucose tolerance test (OGTT); (b) diet regulation and one placebo tablet t.i.d. (N = 48), annual OGTT; (c) diet regulation only (N = 50), annual OGTT; (d) no treatment (N = 61), annual OGTT; and (e) no treatment, OGTT at follow-up (N = 59 at follow-up). In addition, a control group was included comprised of men with normal OGTT (N = 52). At follow-up, 29% of those without diet regulation and medication (group e: N = 59) had developed diabetes. Of those on diet regulation, but without active medication (group b plus group c, N = 98), 13% had diabetes. No individual maintaining tolbutamide and diet regulation (N = 23) had progressed to diabetes. In this group, 80% of those later examined (N = 11) had serum tolbutamide concentrations in the therapeutic range. No individual with initially normal OGTT developed diabetes or impaired OGTT. The findings suggest that normal oral glucose tolerance signifies little risk of progress to impaired glucose tolerance and manifest diabetes, whereas impaired glucose tolerance is associated with a high risk of progression to diabetes. In addition, it seems possible that treatment with diet regulation, in combination with tolbutamide, may prevent or postpone progression from impaired glucose tolerance to manifest diabetes.
在1962年至1965年进行的一项糖尿病检测调查中，228,883名受试者中有2477人（1.1%）在富含碳水化合物的午餐后Clinistix试纸检测显示糖尿阳性。在这2477人中，578人显示口服葡萄糖耐量受损但无明显糖尿病。从这个组中，267名男性被分为五组，并接受以下治疗和对照：（a）饮食调节和每日三次服用0.5克甲苯磺丁脲（N = 49），每年进行口服葡萄糖耐量试验（OGTT）；（b）饮食调节和每日三次服用一片安慰剂（N = 48），每年进行OGTT；（c）仅饮食调节（N = 50），每年进行OGTT；（d）不治疗（N = 61），每年进行OGTT；以及（e）不治疗，随访时进行OGTT（随访时N = 59）。此外，纳入了一个由OGTT正常的男性组成的对照组（N = 52）。随访时，未进行饮食调节和药物治疗的人（e组：N = 59）中有29%患了糖尿病。在进行饮食调节但未使用活性药物的人（b组加c组，N = 98）中，13%患了糖尿病。维持甲苯磺丁脲和饮食调节的人（N = 23）中没有一人进展为糖尿病。在这个组中，后来接受检查的人中有80%（N = 11）血清甲苯磺丁脲浓度在治疗范围内。最初OGTT正常的人中没有一人患糖尿病或OGTT受损。这些发现表明，正常的口服葡萄糖耐量意味着进展为葡萄糖耐量受损和明显糖尿病的风险很小，而葡萄糖耐量受损与进展为糖尿病的高风险相关。此外，饮食调节与甲苯磺丁脲联合治疗似乎有可能预防或推迟从葡萄糖耐量受损进展为明显糖尿病。
