口服果糖对糖尿病病人血糖、胰岛素和C肽的影响及安全性研究

Blood glucose,insulin,C-peptide response and relative safety after orally taking different doses of fructose in type 2 diabetes

目的:探讨口服果糖对糖尿病病人血糖、胰岛素应答的影响及其安全性。方法:10例2型糖尿病病人,分别给予50 g葡萄糖(50G组)、10 g果糖+40 g葡萄糖(10F+40G组)、30 g果糖+20 g葡萄糖(30F+20G组)、40 g果糖+10 g葡萄糖(40F+10G组)和50 g果糖(50F组),观察测定口服前和口服后15、30、60和120 m in的血糖、胰岛素、C肽、血乳酸、血尿酸、血压、心率等的变化,同时密切观察受试者的反应及其安全性。结果:与50G组相比,口服果糖引起的血糖反应小,胰岛素和C肽分泌水平显著下降;30 m in时,10F+40G组、30F+20G组、40F+10G组和50F组胰岛素和C肽分别下降了14.30%、23.73%、40.42%,58.48%和4.62%、14.32%、7.62%、29.33%,并呈剂量效应关系。以50 g葡萄糖为参照,糖尿病病人口服10、30、40和50 g果糖的血糖指数分别是91.8、62.4、43.6和37.5。果糖摄入量超过30 g/次时,血清尿酸和乳酸有明显升高(P<0.05);整个试验过程中病人的血压、心率等无明显改变。结论:糖尿病病人口服适量果糖,可降低餐后血糖、减少胰岛素和C肽的分泌,有助于保护胰岛B细胞功能。摄入果糖对血尿酸和乳酸水平有一定的影响,短时期摄入适量果糖对糖尿病病人是安全的。

Objective： To study the glucose, insulin, C-peptide response and relative safety after orally taking different doses of fructose in type 2 diabetes. Methods： 10 patients with type 2 diabetes, were given 50 g glucose, 10 g fructose ＋ 40 g glucose, 30 g fructose ＋ 20 g glucose, 40 g fructose ＋ 10 g glucose, 50 g fructose respectively, the serum glucose, insuhn, C-peptide, lactic acid, uric acid, heart ratio and blood pressure were measured at 0 min,15 min,30 min,60 min,120 min and relative safety was observed at the same time. Results： The serum glucose, insulin, C-peptide were significantly lower than 50 g glucose group, the insulin, C-peptide decreased 14.30%, 23.73%, 40.42%, 58.48% and 4.62%, 14.32%, 7.62% ,29.33% in 10F ＋40G group,30F ＋ 20G group, 40F ＋ 10G group and 50F group when compared with 50G group, which showed dose-response relationship. The glycemie index was 91.8, 62.4, 43.6, 37.5 in 10F ＋40G group,30F ＋ 20G group,40F ＋ 10G group and 50F group. No adverse effect was observed during the test. Conclusion： It is beneficial to the protection 13 cells of pancreas to orally take different doses of fructose. Fructose taken orally may influence the serum lactic acid.