糖尿病者に於ける葡萄糖負荷後の血中Insulin活性の変動

抄録

Plasma Insulin-like activity (ILA) after the oral administration of 50 gr glucose was investigated in normal and diabetic subjects. Diabetics were classified into four groups ; untreated obese maturity-onset type, well controlled obese maturity-onset type, poorly controlled juvenile lean type and well controlled juvenile type. The most typical subjects in each group were selected for this study. Blood sugar and ILA were measured at 0, 60,120 and 180 minutes following glucose administration. ILA was assayed by the in vivo method that extracts insulin fraction with acid ethanol from peripheral venous blood and uses hypophysectomized-adrenalectomized-rats.
The results are as follows :
In normal subjects, ILA after glucose administration increased markedly with the rise of blood sugar and reached the peak after 60 minutes. Then ILA decreased with the fall of blood sugar and returned to the fasting level or even below it within 180 minutes. In untreated obese maturity-onset diabetics, whose glucose tolerance is severely disturbed, fasting ILA was as high as in normal subjects in spite of the presence of hyperglycemia. And after glucose administration their ILA increased, although it was lower than that in normal subjects. This increased level was sustained for 180 minutes and scarcely decreased in contrast to that in normal subjects whose increased ILA returned to the basal level after 180 minutes. In poorly controlled juvenile lean diabetics, who were treated with insulin and oral hypoglycemic agents the glucose tolerance was still severely disturbed, and showed very low ILA. And this ILA, after glucose administration, scarcely increased or not at all, despite higher elevation of blood sugar. In either maturity-onset or juvenile diabetics, who were controlled well by orall hypoglycemic agents, ILA after glucose administration increased significantly after 60 minutes, and decreased at fasting levels within 180 minutes. Their response was essentially similar to that of normal subjects.
From the above results it may be concluded that untreated obese maturity-onset-diabetics can secrete insulin but cannot utilize it well ; poorly controlled-juvenile lean diabetics have absolute deficiency of insulin due to depleted insulin reserve ; and well controlled diabetics, whether at maturity onset or juvenile, recover the ability to secrete and utilize insulin well.