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目的 :探讨 2型糖尿病高血糖与抑制胰岛素分泌毒性作用的关系。方法 :14例 2型糖尿病病人分为 3组 :单纯饮食疗法和运动组、口服降糖药 (OHA)组、胰岛素治疗组。对 3组治疗前后空腹血糖、食后 2 h血糖、2 4h尿糖、75 g葡萄糖耐量试验和胰岛素水平进行对比分析。结果 :随空腹血糖浓度的升高 ,胰岛素水平也相应升高 ,空腹血糖达 7.8m mol/L时 ,胰岛素浓度达到高峰 (13.8m U/L )。空腹血糖再继续升高时 ,胰岛素的分泌不再增加 ,当空腹血糖 >10 mm ol/L时 ,胰岛素的分泌则呈现下降的趋势。空腹血糖浓度与血浆胰岛素分泌水平表现为一条倒U字型曲线。本研究也发现 ,无论应用何种治疗方法 ,只要血糖得到有效控制 ,胰岛素分泌即可显著增加。结论 :葡萄糖毒性作用是 2型糖尿病胰岛β细胞衰竭发生、发展的一个重要环节。有效地控制血糖水平是打破这一恶性循环的唯一方法。
Objective: To investigate the relationship between hyperglycemia and the inhibition of insulin secretion in type 2 diabetic patients. Methods: Fourteen patients with type 2 diabetes were divided into three groups: simple diet therapy and exercise group, oral hypoglycemic agent (OHA) group and insulin treatment group. Fasting plasma glucose, 2 h postprandial blood glucose, 24 h urine glucose, 75 g glucose tolerance test and insulin levels were compared between the three groups before and after treatment. Results: With fasting blood glucose concentration, insulin level increased accordingly. When fasting blood glucose reached 7.8m mol / L, insulin concentration peaked (13.8m U / L). Fasting blood glucose and then continue to rise, the secretion of insulin no longer increased, when fasting blood glucose> 10 mm ol / L, insulin secretion showed a downward trend. Fasting plasma glucose and plasma insulin levels showed an inverted U-shaped curve. This study also found that no matter what treatment method is used, as long as blood glucose is effectively controlled, insulin secretion can be significantly increased. Conclusion: Glucose toxicity is an important part of the occurrence and development of pancreatic β-cell failure in type 2 diabetes mellitus. Effective control of blood glucose levels is the only way to break this vicious cycle.