Förster H, Steuer A, Albrecht H, Quadbeck R, Dudziak R
Infusionsther Klin Ernahr. 1978 Aug;5(4):185-8.
Serum insulin concentration was measured during infusion of glucose, fructose or sorbitol for several days in polytraumatized patients. The patients are divided in two groups, one group with normal glucose tolerance and a second group, where an extreme disturbance of the glucose utilization was found. In patients with normal glucose tolerance the glucose substitutes had the same metabolic effects as in metabolically healthy volunteers. In patients with disturbed glucose tolerance the glucose substitutes (fructose as well as sorbitol) effected an increase in blood glucose concentration and in serum insulin concentration. It is concluded that the increase in blood glucose concentration causes the increase in serum insulin concentration. Obviously, in a certain group of polytraumatized patients a "metabolic insulin resistence" exists. Therefore, glucose utilization is decreased despite an increase in serum insulin. In most cases the metabolic disturbance in these patients is mastered, if glucose substitutes are used instead of glucose as energy source. However, in many cases glucose can be administered only if insulin is given additionally.
在多创伤患者中，连续数天输注葡萄糖、果糖或山梨醇期间测量血清胰岛素浓度。患者被分为两组，一组葡萄糖耐量正常，另一组发现葡萄糖利用存在严重障碍。在葡萄糖耐量正常的患者中，葡萄糖替代物的代谢作用与代谢健康的志愿者相同。在葡萄糖耐量受损的患者中，葡萄糖替代物（果糖和山梨醇）导致血糖浓度和血清胰岛素浓度升高。得出的结论是，血糖浓度升高导致血清胰岛素浓度升高。显然，在某一组多创伤患者中存在“代谢性胰岛素抵抗”。因此，尽管血清胰岛素增加，但葡萄糖利用仍减少。在大多数情况下，如果使用葡萄糖替代物而非葡萄糖作为能量来源，这些患者的代谢紊乱可以得到控制。然而，在许多情况下，只有额外给予胰岛素才能输注葡萄糖。
