胰岛素依赖型糖尿病患者及正常人黎明现象的观察

本文对10名IDDM患者及10名健康正常人进行了黎明现象的观察。受试者均于0～8am在入睡状态下每小时一次由静脉保留导管内采血,分别测定BG、GG,GH,F和ACTH,结果:IDDM患者BG高于正常人(P<0.01)。IDDM中9/10,正常人8/10例有清晨(5～8am)BG升高倾向,但只有8例IDDM BG升高幅度显著(≥2.5mmol/L),且有统计学意义(P<0.01),1例IDDM及8例正常人BG升高<1(0.2～0.8)mmol/L(P>0.05)。IDDM患者GH、F和GG显著高于正常人,以清晨BG升高幅度显著者更明显。本文提示:清晨BG升高>1mmol/L在IDDM中占80％。黎明现象的发生可能与INS缺乏致细胞内低糖引起多种升糖激素(GH、GG,F等)异常高分泌有关。

The investigation of dawn phenomenon in patients with insulin-dependent diabetes and normal subjects

Dawn phenomenon was investigated in 10 patients with insulin-dependent diabetes(IDDM) and 10 normal subjects. BG, GG, GH, F and ACTH levels were determined hourly during the peroid from 2400 to 0800 in all subjects, INS determined in the normal subjects.The results showed that a tendency of BG increase between 0500 to 0800 was present in 9 of 10 cases of IDDM, 8 of 10 normal subjects, but only in 8 cases of IDDM their BG increased markedly>=2.5mmol/L (P<0.01). In the other cases the BG increases by less than I mmol/l(P<0.05).It suggested that the dawn phenomenon (increase value of BG in early morning more than I mmol/1) was found only in IDDM(80%). We conclude that the pathogenesis of dawn phenomenon in IDDM may be related to oversecretion of F, GH and GG secondery to intracellular hypoglucemia due to lack of insulin.