Tags

Type your tag names separated by a space and hit enter

Free insulin levels and metabolic effects of meal-time bolus and square-wave intraperitoneal insulin infusion in insulin-dependent diabetic patients.
Diabetologia. 1985 Oct; 28(10):728-33.D

Abstract

The intraperitoneal route may offer more physiological insulin delivery through absorption of a proportion of the dose into the portal circulation. We have compared 1-h square-wave and bolus supplemental infusions of a fixed dose of 10 U of intraperitoneal insulin in 6 C-peptide negative insulin-dependent diabetic patients eating a standard breakfast and compared the insulin, glucose and metabolite responses with those of non-diabetic control subjects. Blood glucose profiles were similar on the two experimental days and although the peak glucose levels were not different from normal they were delayed by 30 min (p less than 0.05). Basal free insulin levels were elevated in diabetic patients (square-wave 19.6 +/- 2.3, bolus 18.7 +/- 1.9 mU/l) compared to controls (7.3 +/- 1.0 mU/l, p less than 0.02) and rose more rapidly after bolus injection than infusion. Peak insulin concentration was achieved at 33 +/- 4 min after bolus, 90 +/- 13 min after infusion (p less than 0.02) and 39 +/- 5 min in normal control subjects. The shape of the profile of free insulin concentration was similar after bolus injection and in the controls, but after square-wave infusion the return to baseline was delayed (p less than 0.05). Fasting intermediary metabolite concentrations were normal on both study days in the patients, but serum cortisol levels were significantly elevated and glucagon concentrations low. Metabolite responses to the meal were not significantly different from normal after bolus injection but increases in lactate and glycerol were seen at some time points between 60 and 180 min after infusion. Glucagon levels remained low after square-wave infusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors

Jimenez JT
No affiliation info available
Walford S
No affiliation info available
Home PD
No affiliation info available
Hanning I
No affiliation info available
Alberti KG
No affiliation info available

MeSH

3-Hydroxybutyric AcidAdultAlanineBlood GlucoseDiabetes Mellitus, Type 1Fatty Acids, NonesterifiedFoodGlucagonGlycerolHumansHydrocortisoneHydroxybutyratesInsulinInsulin Infusion SystemsKineticsLactatesLactic AcidMalePeritoneum

Pub Type(s)

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

Language

eng

PubMed ID

3905470

Citation

Jimenez, J T., et al. "Free Insulin Levels and Metabolic Effects of Meal-time Bolus and Square-wave Intraperitoneal Insulin Infusion in Insulin-dependent Diabetic Patients." Diabetologia, vol. 28, no. 10, 1985, pp. 728-33.
Jimenez JT, Walford S, Home PD, et al. Free insulin levels and metabolic effects of meal-time bolus and square-wave intraperitoneal insulin infusion in insulin-dependent diabetic patients. Diabetologia. 1985;28(10):728-33.
Jimenez, J. T., Walford, S., Home, P. D., Hanning, I., & Alberti, K. G. (1985). Free insulin levels and metabolic effects of meal-time bolus and square-wave intraperitoneal insulin infusion in insulin-dependent diabetic patients. Diabetologia, 28(10), 728-33.
Jimenez JT, et al. Free Insulin Levels and Metabolic Effects of Meal-time Bolus and Square-wave Intraperitoneal Insulin Infusion in Insulin-dependent Diabetic Patients. Diabetologia. 1985;28(10):728-33. PubMed PMID: 3905470.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Free insulin levels and metabolic effects of meal-time bolus and square-wave intraperitoneal insulin infusion in insulin-dependent diabetic patients. AU - Jimenez,J T, AU - Walford,S, AU - Home,P D, AU - Hanning,I, AU - Alberti,K G, PY - 1985/10/1/pubmed PY - 1985/10/1/medline PY - 1985/10/1/entrez SP - 728 EP - 33 JF - Diabetologia JO - Diabetologia VL - 28 IS - 10 N2 - The intraperitoneal route may offer more physiological insulin delivery through absorption of a proportion of the dose into the portal circulation. We have compared 1-h square-wave and bolus supplemental infusions of a fixed dose of 10 U of intraperitoneal insulin in 6 C-peptide negative insulin-dependent diabetic patients eating a standard breakfast and compared the insulin, glucose and metabolite responses with those of non-diabetic control subjects. Blood glucose profiles were similar on the two experimental days and although the peak glucose levels were not different from normal they were delayed by 30 min (p less than 0.05). Basal free insulin levels were elevated in diabetic patients (square-wave 19.6 +/- 2.3, bolus 18.7 +/- 1.9 mU/l) compared to controls (7.3 +/- 1.0 mU/l, p less than 0.02) and rose more rapidly after bolus injection than infusion. Peak insulin concentration was achieved at 33 +/- 4 min after bolus, 90 +/- 13 min after infusion (p less than 0.02) and 39 +/- 5 min in normal control subjects. The shape of the profile of free insulin concentration was similar after bolus injection and in the controls, but after square-wave infusion the return to baseline was delayed (p less than 0.05). Fasting intermediary metabolite concentrations were normal on both study days in the patients, but serum cortisol levels were significantly elevated and glucagon concentrations low. Metabolite responses to the meal were not significantly different from normal after bolus injection but increases in lactate and glycerol were seen at some time points between 60 and 180 min after infusion. Glucagon levels remained low after square-wave infusion.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0012-186X UR - https://www.unboundmedicine.com/medline/citation/3905470/Free_insulin_levels_and_metabolic_effects_of_meal_time_bolus_and_square_wave_intraperitoneal_insulin_infusion_in_insulin_dependent_diabetic_patients_ DB - PRIME DP - Unbound Medicine ER -