病例,女性,36岁。糖尿病史9年,持续用胰岛素治疗,剂量不恒定,每日20～30u,反复发生酮症酸中毒住我院。有时为上呼吸道或胃肠道感染诱发,有时则无明显诱因。1991年2月份一次常规复查空腹血糖26.7mmol/L(8:00a.m),当时普通胰岛素用法为早8u,午6u,晚6u,患者述每晚10时左右加餐(约60克主食),如不加餐,凌晨2～3时易出现低血糖反应。入院查体:BP 18.7/11.3kPa,神清,住院后增加 Case, female, 36 years old. Diabetes history of 9 years, continuous treatment with insulin, the dose is not constant, daily 20 ~ 30u, repeated occurrence of ketoacidosis live in our hospital. Sometimes induced by upper respiratory tract or gastrointestinal tract infection, and sometimes no obvious incentive. In 1991 February a routine review of fasting blood glucose 26.7mmol / L (8:00 a.m), when the normal insulin usage as early as 8u, afternoon 6u, night 6u, the patient described about 10 per night dinner (about 60 grams of staple food) , If no meal, 2 to 3 am prone to hypoglycemia. Admission examination: BP 18.7 / 11.3kPa, Shen Qing, increased after hospitalization