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DIABETOLOGIA：2型糖尿病患者经Roux-en-Y胃绕道手术后餐后低血糖

2019-04-04 不详 网络

低血糖症Roux-en-Y胃绕道手术
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<span style="font-size:12.0pt;font-family:宋体;mso-ascii-font-family: Calibri;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:宋体;mso-fareast-theme-font: minor-fareast;mso-hansi-font-family:Ca

餐后低血糖(PPHG)是正常血糖患者行Roux-en-Y胃绕道手术(RYGB)的并发症。在2型糖尿病中，RYGB改善葡萄糖代谢，但这种改善是否与PPHG的后期发展有关尚不清楚。我们研究了接受RYGB治疗的2型糖尿病患者中PPHG的存在及其机制。

共有35名患有2型糖尿病的肥胖患者在术前和术后24个月接受了OGTT检查。PPHG定义为不服用降糖药时血糖≤3.3 mmol/l。通过血糖、胰岛素和c肽浓度的数学模型，用口服葡萄糖胰岛素敏感性指数和细胞功能评估胰岛素敏感性。

结果显示，手术后，35例接受RYGB治疗的患者中有11例发生PPHG。术前PPHG组BMI较低，血糖控制较差，血糖峰值时间较早，且PPHG组糖尿病持续时间较短(p均≤0.05)。此外，PPHG组胰岛素敏感性高于无PPHG组(p = 0.03)。术后两组BMI、空腹血糖、胰岛素水平均有相似程度的下降；在OGTT的第一个小时内，PPHG组的胰岛素分泌比没有PPHG组增加得更多(p = 0.04)。有PPHG的个体比没有PPHG的个体的β细胞葡萄糖敏感性增加得更多(p = 0.002)。同一时间间隔内，PPHG患者术前胰高血糖素样肽1 (GLP-1)反应较低(p = 0.05)，术后升高较多。在OGTT摄取葡萄糖后2小时，PPHG组术后血浆胰高血糖素水平明显低于无PPHG组。

在病态肥胖的2型糖尿病患者中，自发性PPHG可能发生在减肥手术后，而与糖尿病的缓解无关。手术前，患者的持续时间较短，对胰岛素更敏感。手术两年后，这些个体表现出β细胞葡萄糖敏感性增强，并在OGTT早期表现出更强的胰岛素和GLP-1释放。

原始出处：

Daniela Guarino, Diego Moriconi, Postprandial hypoglycaemia after Roux-en-Y gastric bypass in individuals with type 2 diabetes

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    2020-01-08 ms9608593228839890

    #DIA#

    0

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    2019-04-24 ms5439512287675881

    #BET#

    0

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    2019-04-06 aids213

    #2型糖尿病患者#

    0

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    2019-04-06 xue8604

    #糖尿病患者#

    0

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    2019-04-05 misszhang

    谢谢MedSci提供最新的资讯

    0

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