糖尿病

订阅

MedSci主页 / 所有栏目 / 糖尿病

NEJM：男性患者，肚子上长了两团肉，怎么回事？

2017-08-10 MedSci MedSci原创

脂肪肥大胰岛素
关注

患者男性，76岁，存在高血压、慢性肾病以及15年的2型糖尿病史，因肺炎而入院治疗。体格检查显示，患者脐部附近有两片色素沉着区，无痛，橡胶样质感。患者自述10年前开始自行注射胰岛素，注射点正为色素沉着区，每日注射两次（早晨50 units，晚上25 units）。5/6年前脐部附近开始出现此团块，并逐渐增大突出。最终患者诊断为胰岛素介导的脂肪肥大。胰岛素介导的脂肪肥大发生在注射部分，且被认为是重复创

患者男性，76岁，存在高血压、慢性肾病以及15年的2型糖尿病史，因肺炎而入院治疗。体格检查显示，患者脐部附近有两片色素沉着区，无痛，橡胶样质感。患者自述10年前开始自行注射胰岛素，注射点正为色素沉着区，每日注射两次（早晨50 units，晚上25 units）。5/6年前脐部附近开始出现此团块，并逐渐增大突出。最终患者诊断为胰岛素介导的脂肪肥大。胰岛素介导的脂肪肥大发生在注射部分，且被认为是重复创伤的结果，也可能是胰岛素注射的副作用。由于身体各部分胰岛素吸收不同，由此该情况或可导致血糖水平的不稳定。脂肪肥大通常会导致如此病例中明显而呈橡胶样的组织生长，但是本病例中出现色素沉着并不是该疾病的典型表现。通常用于减少脂肪肥大发生风险的方法包括改变胰岛素注射部位，以及使用细针注射等。最后患者肺炎治疗后出院。原始出处：Rajanshu Verma. Insulin-Mediated Lipohypertrophy. N Engl J Med 2017; 377:573August 10, 2017DOI: 10.1056/NEJMicm1701235.

版权声明：
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料，版权均属于梅斯医学所有。非经授权，任何媒体、网站或个人不得转载，授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章，或“梅斯号”自媒体发布的文章，仅系出于传递更多信息之目的，本站仅负责审核内容合规，其内容不代表本站立场，本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系，我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=2054093, encodeId=8799205409312, content=<a href='/topic/show?id=c699e024409' target=_blank style='color:#2F92EE;'>#男性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70244, encryptionId=c699e024409, topicName=男性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 26 12:22:00 CST 2017, time=2017-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232920, encodeId=fb22232920b5, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊）, createdTime=Sat Aug 12 18:53:57 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232255, encodeId=715c23225572, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 10 22:37:22 CST 2017, time=2017-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232234, encodeId=f088232234e8, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Aug 10 21:30:58 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-10-26 hb2008ye

    #男性患者#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2054093, encodeId=8799205409312, content=<a href='/topic/show?id=c699e024409' target=_blank style='color:#2F92EE;'>#男性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70244, encryptionId=c699e024409, topicName=男性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 26 12:22:00 CST 2017, time=2017-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232920, encodeId=fb22232920b5, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊）, createdTime=Sat Aug 12 18:53:57 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232255, encodeId=715c23225572, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 10 22:37:22 CST 2017, time=2017-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232234, encodeId=f088232234e8, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Aug 10 21:30:58 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-12 186****0580(小山羊）

    学习了谢谢了。

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=2054093, encodeId=8799205409312, content=<a href='/topic/show?id=c699e024409' target=_blank style='color:#2F92EE;'>#男性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70244, encryptionId=c699e024409, topicName=男性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 26 12:22:00 CST 2017, time=2017-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232920, encodeId=fb22232920b5, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊）, createdTime=Sat Aug 12 18:53:57 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232255, encodeId=715c23225572, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 10 22:37:22 CST 2017, time=2017-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232234, encodeId=f088232234e8, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Aug 10 21:30:58 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-10 184****9840

    学习了谢谢分享

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=2054093, encodeId=8799205409312, content=<a href='/topic/show?id=c699e024409' target=_blank style='color:#2F92EE;'>#男性患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70244, encryptionId=c699e024409, topicName=男性患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Oct 26 12:22:00 CST 2017, time=2017-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232920, encodeId=fb22232920b5, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊）, createdTime=Sat Aug 12 18:53:57 CST 2017, time=2017-08-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232255, encodeId=715c23225572, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5Kzuf9u71gZhPYMiajRtENwicoAABeQtfXOlic8ibhYSy6DvJZWUDVtjRvTfqBffr1XJ6JLtFB5kHicthl/0, createdBy=d41c2055892, createdName=184****9840, createdTime=Thu Aug 10 22:37:22 CST 2017, time=2017-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=232234, encodeId=f088232234e8, content=好东西学习了！, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=92191944782, createdName=thlabcde, createdTime=Thu Aug 10 21:30:58 CST 2017, time=2017-08-10, status=1, ipAttribution=)]
    2017-08-10 thlabcde

    好东西学习了！

    0