[A chronic alcoholic patient with the development of frank diabetes after heavy drinking and perfect improvement following abstinence from alcohol].

M Yoshitsugu, Y Sekiya, M Ihori
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Abstract

We experienced a chronic alcoholic patient in whom a large intake of alcohol led to the development of frank clinical diabetes, and glucose intolerance and insulin deficiency improved perfectly following abstinence from alcohol. The patient was a 31-year-old male with no diabetes among his relatives. He was a heavy drinker since 12 years, and especially had a large intake of alcohol from Dec. 25 '84 to Jan. 3 '85. From the end of Jan. 1985 he complained of thirst, polydipsia, polyuria and body weight loss from 94 to 69 Kg. On June 25 1985 he admitted for the treatment of diabetes and had abstinence from alcohol. The blood glucose and HbA1 levels were 291 mg/dl and 14.7%, respectively on admission. His 75 g OGTT was diabetic in type and serum insulin response to glucose decreased markedly. Liver function tests were normal, and islet cell antibody was negative. Blood adrenaline, noradrenaline, growth hormone, glucagon, cortisol, T3 and T4 levels were normal. FBS, HbA1 and 75 g OGTT recovered to normal by dietary treatment (1800 kcal) with oral hypoglycemic agents for 8 weeks. This case report suggests that the cause of alcohol-induced diabetes is probably due to impairment of insulin secretion by either alcohol itself or alcohol metabolites.

[重度饮酒后发展为糖尿病的慢性酗酒患者,戒酒后病情完全好转]。
我们经历了一个慢性酒精患者,大量摄入酒精导致临床糖尿病的发展,葡萄糖耐受性和胰岛素缺乏症在戒酒后得到了完美的改善。患者为31岁男性,亲属中无糖尿病。他12年来一直酗酒,尤其是在1984年12月25日至1985年1月3日期间大量饮酒。从1985年1月底开始,他出现口渴、渴渴、多尿,体重从94公斤下降到69公斤。1985年6月25日,他入院治疗糖尿病,并戒酒。入院时血糖和HbA1水平分别为291 mg/dl和14.7%。他的75 g OGTT为糖尿病型,血清胰岛素对葡萄糖的反应明显下降。肝功能检查正常,胰岛细胞抗体阴性。血中肾上腺素、去甲肾上腺素、生长激素、胰高血糖素、皮质醇、T3、T4水平正常。经口服降糖药治疗8周后,FBS、HbA1和75 g OGTT恢复正常。本病例报告提示酒精性糖尿病的原因可能是由于酒精本身或酒精代谢物损害胰岛素分泌。
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