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Early morning glycaemia and the metabolic consequences of delaying breakfast/morning insulin. A comparison of continuous subcutaneous insulin infusion and multiple injection therapy with human isophane or human ultralente insulin at bedtime in insulin-dependent diabetics.
Scand J Clin Lab Invest. 1989 Nov; 49(7):653-9.SJ

Abstract

We studied morning glycaemia and metabolic consequences of delaying morning insulin/breakfast in insulin-dependent diabetics on (i) continuous subcutaneous insulin infusion (CSII) (n = 27), (ii) multiple-injection therapy (MI) with human isophane insulin at bedtime (MI/human isophane) (n = 23) and (iii) MI with human ultralente insulin at bedtime (MI/human ultralente) (n = 14). After an overnight fast, food and insulin (except for the basal infusion on CSII) were withheld, and blood glucose, serum free insulin and serum betahydroxybutyrate were followed from 0800 hours to 1300 hours. At all times blood glucose was lowest on CSII, intermediate on MI/human isophane and highest on MI/human ultralente; serum free insulin was highest on CSII, intermediate on MI/human ultralente and lowest on MI/human isophane; serum betahydroxybutyrate was lowest on CSII, intermediate on MI/human ultralente and highest on MI/human isophane. Blood glucose rose significantly on MI/human isophane (p less than 0.001) and CSII (p less than 0.02); serum free insulin declined significantly on MI/human isophane (p less than 0.001), and betahydroxybutyrate rose significantly on all regimens. Morning metabolic control is better with CSII than MI. Human isophane insulin is preferable to human ultralente insulin overnight in MI. Delaying morning insulin is not advisable on intensified insulin regimens, being most unfavourable with MI/human isophane.

Authors+Show Affiliations

Haakens K
Department of Medicine, Aker Hospital, Oslo, Norway.
Hanssen KF
No affiliation info available
Dahl-Jørgensen K
No affiliation info available
Vaaler S
No affiliation info available
Torjesen P
No affiliation info available
Try K
No affiliation info available

MeSH

3-Hydroxybutyric AcidAdultBlood GlucoseCircadian RhythmDiabetes Mellitus, Type 1HumansHydroxybutyratesInfusion Pumps, ImplantableInjections, SubcutaneousInsulinInsulin Infusion SystemsInsulin, IsophaneInsulin, Long-Acting

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

2692136

Citation

Haakens, K, et al. "Early Morning Glycaemia and the Metabolic Consequences of Delaying Breakfast/morning Insulin. a Comparison of Continuous Subcutaneous Insulin Infusion and Multiple Injection Therapy With Human Isophane or Human Ultralente Insulin at Bedtime in Insulin-dependent Diabetics." Scandinavian Journal of Clinical and Laboratory Investigation, vol. 49, no. 7, 1989, pp. 653-9.
Haakens K, Hanssen KF, Dahl-Jørgensen K, et al. Early morning glycaemia and the metabolic consequences of delaying breakfast/morning insulin. A comparison of continuous subcutaneous insulin infusion and multiple injection therapy with human isophane or human ultralente insulin at bedtime in insulin-dependent diabetics. Scand J Clin Lab Invest. 1989;49(7):653-9.
Haakens, K., Hanssen, K. F., Dahl-Jørgensen, K., Vaaler, S., Torjesen, P., & Try, K. (1989). Early morning glycaemia and the metabolic consequences of delaying breakfast/morning insulin. A comparison of continuous subcutaneous insulin infusion and multiple injection therapy with human isophane or human ultralente insulin at bedtime in insulin-dependent diabetics. Scandinavian Journal of Clinical and Laboratory Investigation, 49(7), 653-9.
Haakens K, et al. Early Morning Glycaemia and the Metabolic Consequences of Delaying Breakfast/morning Insulin. a Comparison of Continuous Subcutaneous Insulin Infusion and Multiple Injection Therapy With Human Isophane or Human Ultralente Insulin at Bedtime in Insulin-dependent Diabetics. Scand J Clin Lab Invest. 1989;49(7):653-9. PubMed PMID: 2692136.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early morning glycaemia and the metabolic consequences of delaying breakfast/morning insulin. A comparison of continuous subcutaneous insulin infusion and multiple injection therapy with human isophane or human ultralente insulin at bedtime in insulin-dependent diabetics. AU - Haakens,K, AU - Hanssen,K F, AU - Dahl-Jørgensen,K, AU - Vaaler,S, AU - Torjesen,P, AU - Try,K, PY - 1989/11/1/pubmed PY - 1989/11/1/medline PY - 1989/11/1/entrez SP - 653 EP - 9 JF - Scandinavian journal of clinical and laboratory investigation JO - Scand J Clin Lab Invest VL - 49 IS - 7 N2 - We studied morning glycaemia and metabolic consequences of delaying morning insulin/breakfast in insulin-dependent diabetics on (i) continuous subcutaneous insulin infusion (CSII) (n = 27), (ii) multiple-injection therapy (MI) with human isophane insulin at bedtime (MI/human isophane) (n = 23) and (iii) MI with human ultralente insulin at bedtime (MI/human ultralente) (n = 14). After an overnight fast, food and insulin (except for the basal infusion on CSII) were withheld, and blood glucose, serum free insulin and serum betahydroxybutyrate were followed from 0800 hours to 1300 hours. At all times blood glucose was lowest on CSII, intermediate on MI/human isophane and highest on MI/human ultralente; serum free insulin was highest on CSII, intermediate on MI/human ultralente and lowest on MI/human isophane; serum betahydroxybutyrate was lowest on CSII, intermediate on MI/human ultralente and highest on MI/human isophane. Blood glucose rose significantly on MI/human isophane (p less than 0.001) and CSII (p less than 0.02); serum free insulin declined significantly on MI/human isophane (p less than 0.001), and betahydroxybutyrate rose significantly on all regimens. Morning metabolic control is better with CSII than MI. Human isophane insulin is preferable to human ultralente insulin overnight in MI. Delaying morning insulin is not advisable on intensified insulin regimens, being most unfavourable with MI/human isophane. SN - 0036-5513 UR - https://www.unboundmedicine.com/medline/citation/2692136/Early_morning_glycaemia_and_the_metabolic_consequences_of_delaying_breakfast/morning_insulin__A_comparison_of_continuous_subcutaneous_insulin_infusion_and_multiple_injection_therapy_with_human_isophane_or_human_ultralente_insulin_at_bedtime_in_insulin_dependent_diabetics_ DB - PRIME DP - Unbound Medicine ER -