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Glucose profiles in a type 1 diabetic patient successively treated with CSII using regular insulin, lispro and an implantable insulin pump.
Diabetes Metab. 2000 May; 26(3):210-4.DM

Abstract

The delayed subcutaneous insulin absorption makes stable blood glucose difficult to achieve in patients with type 1 diabetes, and there is a high risk for severe hypoglycemia. The human insulin analogs demonstrated to circumvent this major limitation of rapid-acting insulin particularly in the context of a continuous subcutaneous insulin infusion (CSII). As insulin profiles generated by implantable insulin pump (IP) are similar to lispro, we studied glucose profiles and the risk for severe hypoglycemia assessed by the low blood glucose index (LBGI) in a patient successively moved from CSII using regular-acting insulin to CSII using lispro and finally to an IP. Insulin delivery with the IP, and to a lesser extent CSII using lispro tend to reduce the average glycemia in comparison with CSII using regular-acting insulin (114.2+/-53.0, 131. 6+/-56.8 and 140.7+/-81.5 mg/dl, respectively). Reduction of glycemic fluctuations assessed by area under the curves was more pronounced during IP therapy in comparison with lispro and with rapid-acting insulin in CSII (789.5, 798.2 and 891.5 h.mg.dl-1, respectively). LBGI remained in the moderate range with IP and CSII using lispro (4.3+/-6.8 and 4.0+/-5.7 respectively), while LBGI was in the high range with rapid-acting insulin (5.5+/-10.2). In conclusion our case report suggests that IP tends to reduce the average glycemia and affect the amplitude of glycemic fluctuations in comparison with CSII using lispro, with an equivalent risk for severe hypoglycemia. A prospective randomized study is needed to compare these two modes of insulin replacement.

Authors+Show Affiliations

Service d'Endocrinologie, Hôpital du Haut-Lévêque, avenue de Magellan, 33604 Pessac, France. bogdan.catargi@ph.u-bordeaux.frNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Comparative Study
Journal Article

Language

eng

PubMed ID

10880895

Citation

Catargi, B, et al. "Glucose Profiles in a Type 1 Diabetic Patient Successively Treated With CSII Using Regular Insulin, Lispro and an Implantable Insulin Pump." Diabetes & Metabolism, vol. 26, no. 3, 2000, pp. 210-4.
Catargi B, Breilh D, Roger P, et al. Glucose profiles in a type 1 diabetic patient successively treated with CSII using regular insulin, lispro and an implantable insulin pump. Diabetes Metab. 2000;26(3):210-4.
Catargi, B., Breilh, D., Roger, P., & Tabarin, A. (2000). Glucose profiles in a type 1 diabetic patient successively treated with CSII using regular insulin, lispro and an implantable insulin pump. Diabetes & Metabolism, 26(3), 210-4.
Catargi B, et al. Glucose Profiles in a Type 1 Diabetic Patient Successively Treated With CSII Using Regular Insulin, Lispro and an Implantable Insulin Pump. Diabetes Metab. 2000;26(3):210-4. PubMed PMID: 10880895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Glucose profiles in a type 1 diabetic patient successively treated with CSII using regular insulin, lispro and an implantable insulin pump. AU - Catargi,B, AU - Breilh,D, AU - Roger,P, AU - Tabarin,A, PY - 2000/7/6/pubmed PY - 2000/9/9/medline PY - 2000/7/6/entrez SP - 210 EP - 4 JF - Diabetes & metabolism JO - Diabetes Metab VL - 26 IS - 3 N2 - The delayed subcutaneous insulin absorption makes stable blood glucose difficult to achieve in patients with type 1 diabetes, and there is a high risk for severe hypoglycemia. The human insulin analogs demonstrated to circumvent this major limitation of rapid-acting insulin particularly in the context of a continuous subcutaneous insulin infusion (CSII). As insulin profiles generated by implantable insulin pump (IP) are similar to lispro, we studied glucose profiles and the risk for severe hypoglycemia assessed by the low blood glucose index (LBGI) in a patient successively moved from CSII using regular-acting insulin to CSII using lispro and finally to an IP. Insulin delivery with the IP, and to a lesser extent CSII using lispro tend to reduce the average glycemia in comparison with CSII using regular-acting insulin (114.2+/-53.0, 131. 6+/-56.8 and 140.7+/-81.5 mg/dl, respectively). Reduction of glycemic fluctuations assessed by area under the curves was more pronounced during IP therapy in comparison with lispro and with rapid-acting insulin in CSII (789.5, 798.2 and 891.5 h.mg.dl-1, respectively). LBGI remained in the moderate range with IP and CSII using lispro (4.3+/-6.8 and 4.0+/-5.7 respectively), while LBGI was in the high range with rapid-acting insulin (5.5+/-10.2). In conclusion our case report suggests that IP tends to reduce the average glycemia and affect the amplitude of glycemic fluctuations in comparison with CSII using lispro, with an equivalent risk for severe hypoglycemia. A prospective randomized study is needed to compare these two modes of insulin replacement. SN - 1262-3636 UR - https://www.unboundmedicine.com/medline/citation/10880895/Glucose_profiles_in_a_type_1_diabetic_patient_successively_treated_with_CSII_using_regular_insulin_lispro_and_an_implantable_insulin_pump_ L2 - https://medlineplus.gov/diabetesmedicines.html DB - PRIME DP - Unbound Medicine ER -