肝源性糖尿病临床特征及治疗

目的研究探讨肝源性糖尿病临床特征及治疗方法。方法对58例肝源性糖尿病患者的临床表现、肝功能及血糖检测结果进行探讨分析(实验组),并从同期患者中随机抽取58例原发性2型糖尿病患者作为对照组。两组患者均实施了胰岛素、C肽释放及OGTT测定。结果所有肝源性糖尿病患者均出现了不同程度的腹胀、乏力、纳差等典型的肝病特征,但只有4例出现"三多一少"等糖尿病典型症状。肝源性糖尿病患者空腹血糖含量的平均值为(6.9±2.5)mmol/L,饮食后2 h血糖含量的平均值为(12.9±2.7)mmol/L。OGTT结果的比较表明肝源性糖尿病患者在空腹时血糖水平比原发性2型糖尿病低,且两组间差异具有统计学意义(P0.05),但用餐后1、2、3 h两组患者血糖水平无显著性差异。胰岛素释放结果及C肽释放水平的比较表明,肝源性糖尿病患者在任何时间段均比对照组高,且两组间差异具有统计学意义(P0.05)。结论肝源性糖尿病的临床症状表现不典型,主要特征为饮食后高血糖,治疗该病的首选药物为胰岛素。

The clinical features of hepatogenous diabetes

Objective To investigate the clinical features and the treatment methods of hepatogenic diabetes.Methods Fifty-eight cases of hepatogenous diabetes were retrospectively analyzed and compared with those of primary type 2 diabetes mellitus.Results All patients with hepatogenous diabetes showed typical characteristics of liver diseases in different degree,fatigue,anorexia,abdominal distension and only 4 cases showed the typical diabetic symptoms such as dry mouth,polydipsia,polyuria,et al.The patients with hepatogenous diabetes showed fasting plasma glucose as （6.9 ± 2.5）mmol/L,and postprandial plasma glucose as （12.9 ±2.7） mmol/L.In OGTT,the patients with hepatogenous diabetes showed a lower level of FPG than that of primary type 2 diabetes mellitus （P ＜ 0.05）.In insulin and C peptide release test,the patients with hepatogenous diabetes showed higher insulin and C peptide values at all the four periods than those of primary type 2 diabetes mellitus.Conclusion Clinical symptoms of patients with hepatogenous diabetes are not typical and the insulin treatment is effective for patients with hepatogenous diabetes.