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患者,男,32岁。1979年开始多饮、多食、多尿、体重下降,在外院诊断为糖尿病。经间断用胰岛素治疗病情未能控制。1年前出现下肢麻木疼痛,排尿费力、费时、射尿无力。近1个月下肢疼痛加剧,夜间难入睡,小便失禁,每天数十次,夜间4～5次,时有尿急,未到厕所即有尿排出,不能控制,于1989年7月15日入院。体查:血压13.33/9.33kPa,神志清楚,消瘦。心肺无异常 ;下腹部可扪及充盈之膀胱;双下肢肌肉萎缩,肌张力下降。B超检查前列腺大小形态正常;膀胱区残余尿量约1000ml,无结石。实验室检查:中段尿培养无细菌生长,尿糖++++,镜检阴性。肝肾功能正常,空腹血胰岛素5.36mu/L(正常值17～49岁10.23±8.01mu/L),血糖15.1mmol/L。诊断:糖尿病Ⅰ
Patient, male, 32 years old. 1979 began to drink more, eat more, more urine, weight loss, diagnosed in the outer hospital for diabetes. After discontinuous use of insulin treatment failed to control the disease. A year ago, lower extremity numbness pain, urination laborious, time-consuming, inefficient urine. Nearly one month exacerbation of lower extremity pain, difficulty falling asleep at night, urinary incontinence, dozens of times a day, night 4 to 5 times, sometimes urinary urgency, not to the toilet that urine excretion, uncontrollable, admitted to hospital on July 15, 1989 . Physical examination: blood pressure 13.33 / 9.33kPa, conscious, weight loss. No abnormal heart and lung; the lower abdomen palpable bladder filling; lower extremity muscle atrophy, decreased muscle tone. B ultrasound examination of prostate size and shape normal; bladder residual urine volume of about 1000ml, no stones. Laboratory tests: no bacterial growth in the middle of urine culture, urine sugar ++++, negative microscopy. Normal liver and kidney function, fasting blood insulin 5.36mu / L (normal 17 to 49 years old 10.23 ± 8.01mu / L), blood glucose 15.1mmol / L. Diagnosis: Diabetes Ⅰ