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Diabetes:口服胰岛素推迟1型糖尿病发病进程

2012-09-27 生物谷 生物谷

1型糖尿病是一种自身免疫性糖尿病,病人体内产生胰岛素的β细胞会被自身免疫系统破坏。1型糖尿病又叫青年发病型糖尿病,这是因为它常常在35岁以前发病,占糖尿病的10%以下。 1型糖尿病是依赖胰岛素治疗的,也就是说病友从发病开始就需使用胰岛素治疗,并且终身使用。原因在于1型糖尿病病友体内胰腺产生胰岛素的细胞已经彻底损坏,从而完全失去了产生胰岛素的功能。在体内胰岛素绝对缺乏的情况下,就会引起血糖水平持续

1型糖尿病是一种自身免疫性糖尿病,病人体内产生胰岛素的β细胞会被自身免疫系统破坏。1型糖尿病又叫青年发病型糖尿病,这是因为它常常在35岁以前发病,占糖尿病的10%以下。

1型糖尿病是依赖胰岛素治疗的,也就是说病友从发病开始就需使用胰岛素治疗,并且终身使用。原因在于1型糖尿病病友体内胰腺产生胰岛素的细胞已经彻底损坏,从而完全失去了产生胰岛素的功能。在体内胰岛素绝对缺乏的情况下,就会引起血糖水平持续升高,出现糖尿病。

我们知道,如果一个人体内有两种自身抗体,其中一个是能对抗胰岛素的抗体,那么他们在五年内有50%的风险患上1型糖尿病。近日,瑞典隆德大学教授Åke Lernmark说:现在这一危险性将大大得到控制。有迹象表明,口服胰岛素可以预防或延缓体内有抗胰岛素抗体的1型糖尿病患者的临床发病,Åke Lernmark表示。

在这项横跨1994至2003年的研究中,募集了体内至少有对抗胰岛素的抗体的1型糖尿病患者,分为口服胰岛素组或安慰剂胶囊组,起初研究结果是令人失望的,许多口服胰岛素组的人酮安慰剂组一样罹患了1型糖尿病。

不过,随后的研究统计分析表明:那些具有较高水平的胰岛素自身抗体患者中,口服胰岛素后会大大推迟1型糖尿病的发病进程。但没有人知道口服胰岛素是如何抵抗1型糖尿病发生的。

然而,Åke Lernmark 认为,其中一个可能的解释是免疫系统逐渐对胃肠道中每天低剂量的胰岛素产生耐受,胰岛素会被当作一个外来物质被免疫系统所排斥。这种推理是基于脱敏效应,所以研究人员认为要再次激起过敏效应就必须逐渐增加胰岛素剂量。

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    2013-09-12 baoya
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胰岛素过敏一例

临床资料患者女,58岁,入院前14年,因口干、多饮在外地医院检测空腹血糖13.8mmol/I。诊断为2型糖尿病(T2DM)。先后予二甲双胍、格列本脲等降糖治疗。 入院前3年,患者因血糖控制不佳,遂改为精蛋白锌重组人胰岛素混合注射液治疗,20d后,出现注射部位皮肤发红,散在多个大小不等的圆形红色皮疹,高出皮肤表面,周围无充血水肿,同时伴瘙痒不适,无心慌气短、呼吸困难。先后改用门冬胰岛素30注射液等

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