热带胰腺性糖尿病的临床特点及实验室研究

CLINICAL AND LABORATORY STUDY ON TROPICAL PANCREATIC DIABETES

目的：研究中国亚热带地区１８例热带胰腺性糖尿病的临床特点及胰岛功能变化。方法：按照１９９４年全国糖尿病普查标准及计划进行初筛；对ＢＭＩ＜１９．５ｋｇ／ｍ２的糖尿病患者询问病史，进行营养调查及体格检查；患者及对照组做胰岛素释放试验，并做空腹胰高血糖素测定。结果：ＴＰＤ患者体重指数＜１９．５ｋｇ／ｍ２，均有儿童时期营养不良史，高血糖但无酮症，其中１０例有经常食用木薯史，部分患者反复腹痛、腹泻。胰岛β－细胞功能部分受损同时伴有α－细胞功能受损。结论：中国亚热带地区存在热带胰腺性糖尿病，其发生明显与营养不良及食用木薯有关。

Objective:To study clinical features and pancreatic function changes of 18 patients with TPD in the subtropical areas of China.Methods:Initial screening was carried out in accordence with the national DM survey scheme in 1994.Historytaking,nutritional survey and somatoscopy were carried out in the DM with BMI<19 5 kg/m 2.Insulin secretion test was performed and fasting glucagon was assayed in all of the patients and control subjects.Resuets:The clinical features of these 18 TPD patients were:body mass index of less than 19 5kg/m 2;poor socioeconomic status or history of childhood malnutrition;hyperglycemia without ketosis;recurrent abldominal pain and steatorrhea in somecases;history of cassava consumption in ten of them.Damage to β cell with part still being remained and concomitant destruction of α cell were seen in these 18 patients.Conclusion:There are TPD patients in the subtropical areas of China,which is obviously related to malnutrition and cassava consumption.Pancreatic function changes play some important roles in the ketosis resistance.