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对96例Ⅱ型糖尿病(NIDDM)病人做进食100g标准粉馒头餐(相当于75g葡萄糖)耐量试验;结果表明随空腹血糖(FPG)升高,2h平均胰岛素分泌量(MIS)呈先升高后下降改变,当FPG>10.0mmol/L,MIS曲线幅度低平;提示轻型或早期NIDDM病人的主要病理生理异常是胰岛素抵抗(IR);重型或晚期病人则是胰岛素分泌降低或不足。2h平均血糖增值(MPGI)在NIDDM组显著高于对照组,但在NIDDM各组之间无明显差异;说明餐后葡萄糖清除能力下降是NIDDM重要特征,且与β细胞功能无关。推测NIDDM病人FPG升高与禁食后肝葡萄糖释放或内源葡萄糖产生过多有关,而餐后高血糖症可能与葡萄糖-胰岛素调节下靶细胞受体与受体后葡萄糖摄取和利用障碍或IR有关。
To 96 cases of type 2 diabetes mellitus (NIDDM) patients eat 100g standard meal steamed bread meal (equivalent to 75g glucose) tolerance test; results show that with fasting blood glucose (FPG), 2h average insulin secretion (MIS) (FPG> 10.0mmol / L, MIS curve amplitude is low) .It is suggested that the main pathophysiologic abnormalities of patients with mild or early NIDDM are insulin resistance (IR), while the patients with severe or advanced disease have reduced or insufficient insulin secretion. 2h mean MPGI in NIDDM group was significantly higher than the control group, but there was no significant difference between the NIDDM groups; indicating that the decline of postprandial glucose clearance is an important feature of NIDDM, and has nothing to do with the β-cell function. It is hypothesized that elevated FPG in NIDDM patients is associated with either post-fasted hepatic glucose release or excessive endogenous glucose production, whereas postprandial hyperglycemia may be associated with impaired glucose uptake and utilization of target cell receptors and receptors after glucose-insulin modulation or IR related.