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1941年Ingle给鼠类应用皮质酮而引起糖尿病,首先提出类固醇性糖尿病(Steroid Diabetes,简称SD)的诊断。1948年Conn等发现人类应用ACTH后引起一过性糖尿病。1950年Sprague用SD这一术语报告一例伴有高血糖和尿糖的柯兴氏综合征患者。目前SD适用于内源性皮质醇增多或糖皮质激素治疗所致的继发性糖尿病。本文着重对后者进行讨论。据估计,在长期接受糖皮质激素治疗的患者中,糖尿病的发生率为5～7％,虽然临床上广泛应用大剂量糖皮质激素长疗程治疗各种疾病,至今国内外有关SD的报告不多,且大部分为个案报告。本文对其发病机理、临床表现、治疗和转归等方面综述如下。一、发病机理在生理情况下,糖皮质激素是胰岛素的反调节激素之一,有升高血糖作用。有关SD的发病机理,至今仍不很清楚,估计与下列因素有关。
In 1941, Ingle used corticosterone to cause diabetes in murine, and first proposed the diagnosis of steroid-induced diabetes (SD). In 1948 Conn and other found that human application of ACTH caused by transient diabetes. In 1950, Sprague used the term SD to report a patient with Cushing ’s syndrome who had hyperglycemia and urine sugar. Currently SD is suitable for endogenous cortisol or glucocorticoid treatment-induced secondary diabetes. This article focuses on the latter discussion. It is estimated that in the long-term treatment of glucocorticoid patients, the incidence of diabetes is 5 to 7%, although widely used in clinical treatment of a wide range of high-dose glucocorticoid diseases, so far the report of SD at home and abroad is not much , Most of which are case reports. This article on its pathogenesis, clinical manifestations, treatment and prognosis, etc. are summarized below. First, the pathogenesis In physiological conditions, glucocorticoid is one of the anti-regulators of insulin, have elevated blood sugar. The pathogenesis of SD, it is still not clear, it is estimated that the following factors.