ステロイド糖尿病に関する臨床的研究 第2編 糖代謝に関する検討

A comparative study was undertaken to examinie the relationship between the cases with steroid diabetes developed after treating with glucocorticoids and the cases not developed after the same treatment, by means of various loading tests including glucose, insulin, prednisolone-glucose, tolbutamide and compound multiple amino acids performed before and after the treatment, The cases studied included of acute and chronic hepatitis and liver cirrhosis. The results obtained are as follows. 1) Nine out of 14 case with the early developed type of steroid diabetes showed glucose assimilation index (KG) of diabetes mellitus before the treatment with glucocorticoids. Five out of 7 cases with the lately developed type showed KG indicated borderline value between normal healthy person and diabetes mellitus. On the other hand, abnormal KG was also seen in 19 out of 29 cases not developed steroid diabetes From these results it was found that there was no significant correlation between KG and development of steroid diabetes. 2) KG after glucocorticoid administration decreased in many of cases with the early developed type of steroid diabetes. On the other hand, KG in cases with the lately developed and not developed showed no significant change between before and after glucocorticoid administration. 3) Insulin sensitivity tended to decrease after glucocorticoid adminstration, but it was no significant difference as compared with that before glucocorticoid administration. Insulin sensitivity after glucocorticoid administration in cases with steroid diabetes developed tended to decrease as compared with that in cases not developed. 4) There was not always close relation between the influence of prednisolone on intravenous glucose tolerance test and the appearance of steroid diabetes. 5) Some of cases with the early developed type showed diabetic response in tolbutamide tolerance test, but no diabetic response was found in cases with the lately developed and not developed type. 6) The rate of increase in blood sugure, pyruvic acid and amino-N in blood and urine after giving glucocorticoid Its rate was found to be higher in cases with steroid disbetes deveoloped either early or lately as compared with cases not developed, showing the similar rate to that after administration of ths compound multiple amino acid in diabetes mellitus. 7) The rate of increase in blood sugure after administration of the compound multiple amino acids tended to be higher in cases treated with the combination of glucocorticoid and anabolic steroid as compared with cases treated with glucocorticoid alone. 8) There was no significant correlation between the results of various loading tests in cluding glucose, insulin, prednisolone-glucose, tolbutamide and compound multiple amino acids and the findings of biochemical liver function tests and liver biopsy.