一時期ケトージスを示した若年性糖尿病の緩解期におけるインスリン反応

抄録

The marked amelioration in the intensity of diabetes mellitus has been frequently reported in young patients. However, little is known about the mechanism of this process. In order to throw light on this matter, serum insulin and glucose responses to various stimuli have been investigated in two juvenile diabetics with ketosis just before initiation of the therapy and six months or more after discontinuation of insulin injection. No elevation of serum insulin level was observed either after an intravenous administration of 25 g glucose plus 1 mg glucagon in one case or during an oral glucose tolerance test in another in a stage of ketosis. On the contrary, these patients showed the normal or slightly impaired insulin responses in magnitude as well as in pattern during a remission of this disease which was attained after the insulin therapy for several months in both cases.
These results indicate that unresponsiveness of β-cell to the potent stimuli resulting in severe diabetes mellitus with ketosis is reversible in some cases. In addition, they suggest a close relationship between the improvement of the disturbed glucose metabolism and the restoration of responsiveness of β-cell to the stimuli.