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題名 | Clinical Courses and Changes of Pancreatic β-Cell Function in Young-Onset Diabetics: Report of Two Cases=年輕發病糖尿病患者的臨床表現及胰臟貝他細胞功能之變化:二例報告 |
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作者 | 黃兆山; 莊峻鍠; Hwang, Jawl-shan; Juang, Jyuhn-huarng; |
期刊 | 長庚醫學 |
出版日期 | 19980900 |
卷期 | 21:3 1998.09[民87.09] |
頁次 | 頁328-332 |
分類號 | 415.937 |
語文 | eng |
關鍵詞 | 年輕發病糖尿病患者; 貝他細胞功能; 人類白血球抗原; Young-onset diabetics; β-cell function; Human leukocyte antigen; HLA; |
中文摘要 | 對某些年輕糖尿病患者而言,正確的分類雖然困難,但在決定其治療卻非常重要 。本文報告二位年輕發病糖尿病患者不同的臨床表現及其胰臟貝他細胞功能之變化。此二位 患者於發病之初皆接受胰島素治療,後來因其貝他細胞功能與非胰島素依賴型糖尿病患者相 當而改以口服降血糖藥物治療。第一位患者其血糖控制及貝他細胞功逐漸惡化,以致最後需 要使用胰島素治療。而第二位患者雖然血糖控制並不理想,但其貝他細胞功能至今仍維持良 好。最近他因改善飲食及口服降血糖藥物之遵循性,使得血糖接近正常。很明顯地,第一位 患者是緩慢進行性的胰島素依賴型糖尿病病人,而第二位患者則是年輕的非胰島素依賴型糖 尿病病人。我們發現第一位患者具有人類白血球抗原DR3,而第二位患者則無,這更支持上 述的分類。 |
英文摘要 | Accurate classification of diabetes in some young patients is difficult but clearly of importance in deciding the appropriate treatment. We report the different clinical courses and ��-cell function changes in 2 young- onset diabetics. In the beginning, each of them was considered to be a patient with insulin- dependent diabetes mellitus (IDDM) and was treated with insulin. Then, treatment was shifted from insulin to oral hypoglycemic agents (OHA) because each patient's ��-cell function was comparable to that of patients with non-insulin-dependent diabetes mellitus (NIDDM). In case 1, the patient's glycemic control and ��-cell function progressively deteriorated and finally insulin therapy was required. In case 2, the patient was continuously treated with OHA. Although his blood glucose was not well-controlled, his ��-cell function had been well-preserved. Recently he achieved near-normoglycemia by improving his diet and OHA compliance. Clearly, case 1 was a slowly progressive Type 1 DM patient and case 2 was a young type 2 DM patient. This classification was further supported by the finding that the patient in case 1 had human leukocyte antigen (HLA)-DR3, but the pahent in case 2 did not. |
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