高血糖毒性致2型糖尿病磺脲类继发性失效的临床分析

SECONDARY INEFFICACY OF SULFAUREA DRUGS CAUSED BY HYPERGLUCOSEMIA TOXIN IN CASES OF 2-TYPE DIABETES MELLITUS

目的：研究2型糖尿病高血糖毒性作用与磺脲类药物继发性失效的关系。方法：选择42例服用磺脲类药物血糖控制不佳2型糖尿病患者住院治疗前后葡萄糖耐量试验（OGTT）、胰岛素释放试验、C肽和胰岛素释放指数（IS／BS）与正常对照组比较。如果：2型糖尿病患者胰岛素释放水平及IS／BS显著低于对照组（P＜0．01）。经胰岛素治疗约1月后2型糖尿病OGTT和血糖曲线下面积测定与治疗前相比均显著下降（P＜0．01）。空腹C肽水平与对照组相比无显著差异（P＜0．05）。结论：2型糖尿病患者长期高血糖毒性作用影响机体对胰岛素的敏感性，导致磺脲类药物继发性失效。

Objective To study the relationship between hyperglucosemia toxin and secondary inefficacy of sulfaurea drugs in cases of 2 - type diabetes millitus(DM) Methods 42 inpatients with 2-type DM whose glucose levels of serum wer unsatisfiedly controlled by sulfaurea drugs were collected , and the levels of OGTT, insulin-release, C -peptide and IS/BS were determined before and after treatments , and then the levds were compared with those of control groups . Results. Results The levels of insulin-release and IB/BS of the DM groupe were significantly lower than those of the control group (P<0. 01). The levels of OGTT and AUC of glucose decreased remarkably after the treatment with insulin when compared with those before the treatment (P<0. 01). Conclusion In 2-type DM, continuing hyperglucosemia toxin can affect the sensitivity of the body to insulin and lead to the secondary inefficacy of sulfaurea drugs.