Changes in Insulin Secretion and Insulin Sensitivity during Treatment of Patients with Soft Drink Ketosis.

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  • 清涼飲料水ケトーシスにおけるインスリン分泌とインスリン感受性の治療による変化

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To investigate the relative contribution of insulin secretion and insulin sensitivity in the pathophysiology of soft drink ketosis, we examined changes in insulin secretion and action in seven diabetic patients. All patients were treated with intensive insulin therapy, and insulin treatment was substequently withdrawn. Insulin secretion and insulin sensitivity were measured after correction of ketosis. The tests were repeated after withdrawal of insulin treatment.<BR>Insulin secretion measured by24-hr urinary C-peptide excreation did not change significantly during treatment. However, insulin secretion measured by the fasting serum C-peptide method increased significantly from1.0 (SD0.7) to1.6 (0.7) ng/ml (p=0.015). The postprandial 2-hr serum C-peptide level also increased significantly from1.7 (0.8) to7.1 (4.6) ng/ml (p=0.018). Insulin sensitivity was measured by the K index of the insulin tolerance test (KITT). The value of KITT significantly improved during treatment from1.27 (0.99) to3.80 (0.86)%/min (p<0.01). Insulin treatment significantly decreased the serum triglyceride level from166.1 (86.1) to 92.3 (48.7) mg/dl (p=0.014). However, the same treatment did not change the serum levels of totaland HDL-cholesterol. A rise in insulin secretion and improvement in insulin sensitivity were observed in all study patients. We conclude that insulin deficiency and insulin resistance associated with marked hyperglycemia may play an important role in the pathophysiology of soft drink ketosis.

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