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Journal of the Korean Academy of Family Medicine 2001;22(11):1622-1629.
Published online November 1, 2001.
An approach to the treatment of the hypoglycemia dropped after meal.
Seng Wan Oh, Jae Tack Rhee, Song Byung Kim, Kwang Tai Ahn
Department of Family Medicine, Tae-jeon Sung-sim hospital, Korea.
식후 곧 바로 떨어지는 저혈당 치료의 접근
오성환, 이재택, 김순병, 안광태
대전성심병원 가정의학과
Abstract
Background
: Many patients with Type I Diabetes Mellitus treated by insulin therapy were observed their blood sugar dropped even after meal. The ecology and treatment for this phenomenon was unknown. A clinical research making an approach to treat this phenomenon is inevitable.

Methods : 9 patients whose blood sugar dropped right after meal (from 15 minutes to 1 hour) were selected among 58 IDDM(Insulin Dependant Diabetes Mellitus) patients admitted in Daejon Sungsim hospital from March 1999 to Feb. 2000. The subjects were consist of 6 female and 3 male, average age was 57.2. Blood samples were taken from their capillaries and measured by Super Glucocard Ⅱ glucometer. Insulin was injected 30 minutes before breakfast and 50% glucose 30 ml was taken orally 15 minutes after the insulin injection. Breakfast was taken 15 minutes after the glucose taken. Blood sugar was measured 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 120 minutes and 2 hours after a breakfast.

Results : Though average blood sugar dropped after breakfast was 44.5 ㎎/㎗, average blood sugar after taken 50% glucose 30 ml was 114.1 ㎎/㎗. 2 patients had good effect among 3 male patients and every 6 female patients had good effect.

Conclusion : Taking 50% glucose 30 ml in oral 15 minutes after insulin injection improved the IDDM patient's blood sugar drop right after meal.
초록
연구배경 : 인슐린 치료를 받는 많은 제 1형 당뇨병 환자들에서 식후 곧 바로 혈당이 떨어지는 것이 확인되었다. 그러나 그 원인과 치료법이 잘 알려져 있지 않아 그 현상의 치료법을 발견하기 위한 임상연구가 필수적이었다.

방법 : 1999년 3월부터 2000년 2월까지 인슐린 의존성 당뇨병으로 대전성심병원에 입원한 환자 58명 중에 남자 3명, 여자 6명으로 평균 연령 57.2세였다. 환자 58명을 대상으로 식후 곧바로 (식후 15분-식후1시간)저혈당에 떨어지는 9명 환자를 선별하여 임상대상으로 하였다. 혈당 측정기는 super glucocard Ⅱ를 사용하였으며 모세혈관의 혈액으로 혈당 측정하였다. 인슐린을 식전 30분에 주사맞고 난후 15분에 포도당 50% 30ml을 복용케한 후 15분 후에 식사를 하게 하였다. 그리고 15분부터 20, 25, 30, 35, 40, 45, 50, 55, 60, 90, 120분까지 측정하였다.

결과 : 연구대상자 남자 환자 3명 중 2명은 효과를 얻었고, 여자 환자 모두 6명은 좋은 효과를 얻었다. 식후 곧 바로 떨어지는 치료전 저혈당의 평균 혈당은 44.5 mg/dl 이였으나 포도당 50% 30ml를 복용 후 측정한 평균 혈당은 114.1 mg/dl으로 상당히 좋은 결과였다.

결론 : 인슐린 의존성 당뇨병 환자의 식후 곧 바로 떨어지는 저혈당은 인슐린 주사후 15분후에 50% 포도당 30ml를 복용하게 해서 개선되었다.
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