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晚近低蛋白、低磷饮食广泛地使用于尿毒症病人以延缓肾功能衰竭的进展。但对糖尿病者伴慢性肾衰增加饮食中糖含量可能给血糖控制带来困难。作者比较了胰岛素依赖性糖尿病伴慢性肾衰8例,予以低蛋白饮食3个月后,胰岛素需要量和组织胰岛素敏感性的改变。病人和方法男女各4例,年龄为31～74岁,使用胰岛素时间为3～35年,平均使用胰岛素为38.3±3.2U/d,所有病例均有糖尿病视网膜病变,其中2例有糖尿病神经病变。平均血肌酐393±12.7μmol/L,尿素氮22±1.5mmol/L。使用降压药者在治疗过程中不变,避免使用影响肾功能和组织胰岛素敏感性的降压药。
Recent low-protein, low phosphorus diet is widely used in patients with uremia to delay the progress of renal failure. However, diabetic patients with chronic renal failure to increase the sugar content of diet may cause difficulties in glycemic control. The authors compared 8 patients with insulin-dependent diabetes mellitus and chronic renal failure who were treated with a low-protein diet for 3 months to determine the change in insulin requirements and insulin sensitivity. Patients and methods Male and female 4 patients, aged from 31 to 74 years, the use of insulin for 3 to 35 years, the average use of insulin was 38.3 ± 3.2U / d, all cases have diabetic retinopathy, including 2 cases of diabetic neuropathy . The average serum creatinine 393 ± 12.7μmol / L, urea nitrogen 22 ± 1.5mmol / L. The use of antihypertensive drugs in the treatment of the same, to avoid the use of antihypertensive drugs affect renal function and tissue insulin sensitivity.