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Influence of insulin infusion kinetics of an artificial beta cell on blood glucose control in insulin-dependent diabetics.

Abstract

The influence of different control modes for insulin infusion with an artificial beta cell was examined in 41 insulin-dependent diabetics. In 21 Patients, oral glucose tolerance tests were performed with control modes characterized either by low dynamic and high static gain (type I, 10 patients) or high dynamic and low static gain (type III, 11 patients). The change from type I to type III control mode effected an increase of initial insulin infusion rates (91 +/- 59 to 313 +/- 81 mU/min 10-20 min after glucose ingestion) and a decrease of infusion rates during the following phase of the 3-hour observation period (28.2 +/- 4.2 to 18.1 +/- 2.8 U) in patients whose blood glucose curves were completely normalized. Suppression of plasma glucagon levels, observed in 5 healthy control subjects, was not fully restored to normal in these patients. In another 20 insulin-dependent diabetics, daily insulin requirements form the artificial beta cell were determined by employing two control modes (types II and III) comparable in static control but different in dynamic control. Gain of dynamic control, especially in the range of falling glucose levels, was higher in type III control mode (15 patients) than in type II mode (5 patients). These insulin requirements were compared to the insulin doses necessary for subcutaneous treatment. While intravenous insulin requirements were much higher when type II control mode was employed (78.2 +/- 10.2%), during application of type III mode, intravenous insulin requirements were only 10.8 +/- 5.5% higher than subcutaneous doses. We conclude from these data that early increases in insulin infusion rates followed by a rapid decrease seem to reduce insulin requirements after glucose ingestion. A high-gain dynamic control is the basis for this insulin infusion profile.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

395094

Citation

Kerner, W, et al. "Influence of Insulin Infusion Kinetics of an Artificial Beta Cell On Blood Glucose Control in Insulin-dependent Diabetics." Hormone and Metabolic Research. Supplement Series, 1979, pp. 71-80.
Kerner W, Beischer W, Maier V, et al. Influence of insulin infusion kinetics of an artificial beta cell on blood glucose control in insulin-dependent diabetics. Horm Metab Res Suppl. 1979.
Kerner, W., Beischer, W., Maier, V., & Pfeiffer, E. F. (1979). Influence of insulin infusion kinetics of an artificial beta cell on blood glucose control in insulin-dependent diabetics. Hormone and Metabolic Research. Supplement Series, (8), 71-80.
Kerner W, et al. Influence of Insulin Infusion Kinetics of an Artificial Beta Cell On Blood Glucose Control in Insulin-dependent Diabetics. Horm Metab Res Suppl. 1979;(8)71-80. PubMed PMID: 395094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of insulin infusion kinetics of an artificial beta cell on blood glucose control in insulin-dependent diabetics. AU - Kerner,W, AU - Beischer,W, AU - Maier,V, AU - Pfeiffer,E F, PY - 1979/1/1/pubmed PY - 1979/1/1/medline PY - 1979/1/1/entrez SP - 71 EP - 80 JF - Hormone and metabolic research. Supplement series JO - Horm Metab Res Suppl IS - 8 N2 - The influence of different control modes for insulin infusion with an artificial beta cell was examined in 41 insulin-dependent diabetics. In 21 Patients, oral glucose tolerance tests were performed with control modes characterized either by low dynamic and high static gain (type I, 10 patients) or high dynamic and low static gain (type III, 11 patients). The change from type I to type III control mode effected an increase of initial insulin infusion rates (91 +/- 59 to 313 +/- 81 mU/min 10-20 min after glucose ingestion) and a decrease of infusion rates during the following phase of the 3-hour observation period (28.2 +/- 4.2 to 18.1 +/- 2.8 U) in patients whose blood glucose curves were completely normalized. Suppression of plasma glucagon levels, observed in 5 healthy control subjects, was not fully restored to normal in these patients. In another 20 insulin-dependent diabetics, daily insulin requirements form the artificial beta cell were determined by employing two control modes (types II and III) comparable in static control but different in dynamic control. Gain of dynamic control, especially in the range of falling glucose levels, was higher in type III control mode (15 patients) than in type II mode (5 patients). These insulin requirements were compared to the insulin doses necessary for subcutaneous treatment. While intravenous insulin requirements were much higher when type II control mode was employed (78.2 +/- 10.2%), during application of type III mode, intravenous insulin requirements were only 10.8 +/- 5.5% higher than subcutaneous doses. We conclude from these data that early increases in insulin infusion rates followed by a rapid decrease seem to reduce insulin requirements after glucose ingestion. A high-gain dynamic control is the basis for this insulin infusion profile. SN - 0170-5903 UR - https://www.unboundmedicine.com/medline/citation/395094/Influence_of_insulin_infusion_kinetics_of_an_artificial_beta_cell_on_blood_glucose_control_in_insulin_dependent_diabetics_ L2 - https://medlineplus.gov/diabetesmedicines.html DB - PRIME DP - Unbound Medicine ER -