Rybka J
Interní klinika Institu postgraduálního vzdĕlání ve zdravotnictví, Zlin.
Vnitr Lek. 1994 May;40(5):320-4.
Although NIDDM is by far the most frequent form of diabetes, the pathogenesis is less clear and even more controversial than in IDDM. There is a heterogeneity of IDDM and NIDDM and there are reasons why the two types should be considered different diseases although we do not know exactly why. NIDDM is the result of a disbalance between insulin sensitivity and insulin secretion. Fully developed NIDDM syndrome calls for the concurrent existence of both main defects, i.e. insulin resistance and deteriorated B-cell function. It is important that the two defects must occur simultaneously, only then marked glucose intolerance develops. Concurrent hyperglycaemia and hyperinsulinaemia on fasting suggest severe insulin resistance. Investigations provide evidence that hyperinsulinaemia is a predictor of the final development of IGT and IDDM and it was demonstrated that hyperglycaemia is a predictor of development of NIDDM in Caucasians.
尽管2型糖尿病是目前最常见的糖尿病类型,但其发病机制比1型糖尿病更不清楚,甚至更具争议性。1型糖尿病和2型糖尿病存在异质性,尽管我们并不确切知道原因,但有理由认为这两种类型应被视为不同的疾病。2型糖尿病是胰岛素敏感性和胰岛素分泌失衡的结果。完全发展的2型糖尿病综合征需要同时存在两个主要缺陷,即胰岛素抵抗和β细胞功能恶化。重要的是,这两个缺陷必须同时出现,只有这样才会出现明显的葡萄糖不耐受。空腹时同时出现高血糖和高胰岛素血症提示严重的胰岛素抵抗。研究提供的证据表明,高胰岛素血症是糖耐量受损和1型糖尿病最终发展的预测指标,并且已经证明高血糖是白种人发生2型糖尿病的预测指标。