Ohneda A, Watanabe K, Horigome K, Sakai T, Kai Y, Oikawa S
J Clin Endocrinol Metab. 1978 Mar;46(3):504-10. doi: 10.1210/jcem-46-3-504.
In order to determine pancreatic alpha cell function in diabetes mellitus, plasma glucagon responses to either an oral glucose load or insulin-induced hypoglycemia were investigated. Plasma glucagon in 6 normal control subjects fell significantly after the administration of glucose, whereas the levels of plasma glucagon did not decrease after glucose ingestion in patients with diabetes mellitus. In the group with severe diabetes, whose fasting blood glucose exceeded 200 mg/100 ml, the plasma glucagon level rose after glucose administration instead of decreasing. In 6 patients with diabetes mellitus, plasma glucagon did not decrease but rather increased during a glucose tolerance test which was performed after treatment with insulin and/or diet. In 6 control subjects, there was a remarkable rise of plasma glucagon in response to insulin-induced hypoglycemia. In contrast, no significant rise in plasma glucagon was demonstrated in 19 diabetic subjects undergoing intravenous insulin test. Seven patients, in whom an insulin test was repeated after treatment with insulin, sulfonylurea, or diet had a small rise in peak plasma glucagon and an increase in the integrated area under the glucagon response curve. It is concluded that the abnormal glucagon response to changes in blood glucose might be a primary defect in diabetes mellitus.
为了确定糖尿病患者胰腺α细胞的功能，研究了血浆胰高血糖素对口服葡萄糖负荷或胰岛素诱导的低血糖的反应。6名正常对照受试者在给予葡萄糖后血浆胰高血糖素显著下降，而糖尿病患者在摄入葡萄糖后血浆胰高血糖素水平并未降低。在空腹血糖超过200mg/100ml的重度糖尿病组中，给予葡萄糖后血浆胰高血糖素水平上升而非下降。6名糖尿病患者在接受胰岛素和/或饮食治疗后进行葡萄糖耐量试验时，血浆胰高血糖素没有下降反而升高。6名对照受试者在胰岛素诱导的低血糖反应中血浆胰高血糖素显著升高。相比之下，19名接受静脉胰岛素试验的糖尿病受试者血浆胰高血糖素没有显著升高。7名患者在接受胰岛素、磺脲类药物或饮食治疗后重复进行胰岛素试验，其血浆胰高血糖素峰值略有上升，胰高血糖素反应曲线下的积分面积增加。结论是，血糖变化时胰高血糖素反应异常可能是糖尿病的原发性缺陷。
