CAJ | 학술논문

本文为国内外首次报道1例艾塞那肽应用于血糖难以控制的2型糖尿病并腹膜透析患者.患者女,66岁,因发现血糖升高10余年,血糖控制差14月入院.既往有原发性高血压30年,非卧床持续性腹膜透析(CAPD)14月病史.体重83kg,BMI 31.2kg/m2,HbA1C 9.6%.C 肽释放试验提示高胰岛素血症.胰岛素强化治疗总量60单位/天,血糖控制差.予皮下注射艾塞那肽5ug 2次/日,5天后血糖改善.随访1月后空腹血浆葡萄糖7mmol/L,体重下降至80kg,BMI 30.1kg/m2.2个月后出现严重胃纳差终止艾塞那肽治疗.予胰岛素总量48单位/天,血糖可控制.对血糖难以控制的行 CAPD 治疗的2型糖尿病患者,艾塞那肽可能是比较好的治疗选择.
본문위국내외수차보도1례애새나태응용우혈당난이공제적2형당뇨병병복막투석환자.환자녀,66세,인발현혈당승고10여년,혈당공제차14월입원.기왕유원발성고혈압30년,비와상지속성복막투석(CAPD)14월병사.체중83kg,BMI 31.2kg/m2,HbA1C 9.6%.C 태석방시험제시고이도소혈증.이도소강화치료총량60단위/천,혈당공제차.여피하주사애새나태5ug 2차/일,5천후혈당개선.수방1월후공복혈장포도당7mmol/L,체중하강지80kg,BMI 30.1kg/m2.2개월후출현엄중위납차종지애새나태치료.여이도소총량48단위/천,혈당가공제.대혈당난이공제적행 CAPD 치료적2형당뇨병환자,애새나태가능시비교호적치료선택.
We report the first case of Exenatide used in type 2 diabetic patient who had worsening hyperglycemia with continuous ambulatory peritoneal dialysis (CAPD). A 66-year-old woman, 10-year history of type 2 diabetes presented with worsening hyperglycemia 14-month. She had essential hypertensive for 30 years and received CAPD treatment for 14 moths. Weight 83kg,body mass index(BMI) 31.2kg/m2, HbA1C 9.6%,C-peptide release test suggested hyperinsulinemia. The blood glucose control was poor treated with intensive insulin therapy by a total of 60 units per day. When Exenatide 5 ug twice daily by subcutaneous injection was added, blood glucose decreased for 5 days. The fasting plasma glucose was 7mmol/L, weight was 80kg,BMI was 30.1kg/m2 1-month later. However, Exenatide had been stoped for sever appetite suppression, blood glucose could be controled by insulin with 48 units per day. Exenatide could be a promising strategy for type 2 diabetic patients with severe hyperglycemia in CAPD.