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Substitution of basal delivery of insulin by proinsulin in type I diabetic patients under CSII.

Abstract

In seven C-peptide negative type I diabetic patients conventional insulin therapy was replaced by CSII using biosynthetic human insulin. After a pretest period of 1-3 days duration, the patients received in randomized order basal subcutaneous infusion of either biosynthetic human proinsulin (assumed potency 4 U/mg) or insulin for two days each. For meals, insulin was given throughout the study. Insulin doses were adjusted to the patients requirements during the prephase. Afterwards changes of basal rates were allowed only in case of nocturnal hypoglycemia; bolus doses were modified when premeal glucose concentrations were outside the range from 80 to 120 mg/dl. During the test period with basal proinsulin infusion, plasma glucose control (MBG, MAGE, M-value) was significantly better (P less than 0.05) when compared to periods with basal insulin infusion. Basal rates of insulin and proinsulin as well as bolus doses of insulin were similar at all study periods. It is concluded that subcutaneous basal proinsulin infusion, supplemented by subcutaneous premeal insulin administration, can be used for glucose control of patients with type I diabetes. As basal proinsulin delivery gives significantly better results than basal insulin delivery, the question arises whether the present formulation of proinsulin is equipotent to insulin formulations.

Authors+Show Affiliations

,

Medizinische Klinik und Poliklinik der Universität Ulm, Germany.

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Source

MeSH

Adult
Blood Glucose
Diabetes Mellitus, Type 1
Drug Therapy, Combination
Female
Humans
Insulin
Insulin Infusion Systems
Male
Middle Aged
Proinsulin

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

3056816

Citation

TY - JOUR T1 - Substitution of basal delivery of insulin by proinsulin in type I diabetic patients under CSII. AU - Kerner,W, AU - Wallmüller,G, AU - Beischer,W, AU - Pfeiffer,E F, PY - 1988/1/1/pubmed PY - 1988/1/1/medline PY - 1988/1/1/entrez SP - 74 EP - 7 JF - Hormone and metabolic research. Supplement series JO - Horm. Metab. Res. Suppl. VL - 18 N2 - In seven C-peptide negative type I diabetic patients conventional insulin therapy was replaced by CSII using biosynthetic human insulin. After a pretest period of 1-3 days duration, the patients received in randomized order basal subcutaneous infusion of either biosynthetic human proinsulin (assumed potency 4 U/mg) or insulin for two days each. For meals, insulin was given throughout the study. Insulin doses were adjusted to the patients requirements during the prephase. Afterwards changes of basal rates were allowed only in case of nocturnal hypoglycemia; bolus doses were modified when premeal glucose concentrations were outside the range from 80 to 120 mg/dl. During the test period with basal proinsulin infusion, plasma glucose control (MBG, MAGE, M-value) was significantly better (P less than 0.05) when compared to periods with basal insulin infusion. Basal rates of insulin and proinsulin as well as bolus doses of insulin were similar at all study periods. It is concluded that subcutaneous basal proinsulin infusion, supplemented by subcutaneous premeal insulin administration, can be used for glucose control of patients with type I diabetes. As basal proinsulin delivery gives significantly better results than basal insulin delivery, the question arises whether the present formulation of proinsulin is equipotent to insulin formulations. SN - 0170-5903 UR - https://www.unboundmedicine.com/medline/citation/3056816/abstract/Substitution_of_basal_delivery_of_insulin_by_proinsulin_in_type_I_diabetic_patients_under_CSII_ L2 - https://medlineplus.gov/diabetesmedicines.html ER -