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[Progress and developments in insulin therapy].
Schweiz Med Wochenschr. 1979 Dec 01; 109(46):1802-7.SM

Abstract

BANTING and BEST revolutionized diabetes therapy with the discovery of insulin 57 years ago. Since then, progress in this area has been slow despite tremendous reseach efforts. The subcutaneous injection of a depot insulin does not provide optimal control of blood sugar. True progress has been brought about by intravenous insulin administration for the management of diabetic coma. The authors do not recommend ultra low dose therapy. The prognosis of diabetic coma is much better than 20 years ago, in particular because of much improved and continuous supervision of the circulation (CVP, ECG, K+ etc.). Pancreas and islet transplantation fail in man due to immunological rejection. The "artificial pancreas" with a glucose sensor is useful for research purposes, and for controlling blood sugar for a few days at most. The implantable glucose sensor is not yet in sight. The authors have treated diabetics successfully with a programmable flexible open loop infusion program. The basal insulin infusion rate can be varied from 0.25 to 2 U/h, and rectangular one hour extra insulin infusions between 2 and 10 U/h are superimposed by pushing a button on the steering unit. The pump automatically switches back to the basal rate after one hour. No hypoglycemic reactions have been observed in patients on ths program on the ward or at home. At present, technical problems with the catheter remain to be solved before this simple therapeutic approach can be applied routinely.

Authors

Froesch ER
No affiliation info available
Blatter G
No affiliation info available
Candinas R
No affiliation info available
Süsstrunk H
No affiliation info available
Morell B
No affiliation info available

MeSH

AdolescentAdultAgedBlood GlucoseDiabetes MellitusDiabetic ComaDose-Response Relationship, DrugHumansInjections, IntravenousInsulinMiddle AgedPotassium

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

515716

Citation

Froesch, E R., et al. "[Progress and Developments in Insulin Therapy]." Schweizerische Medizinische Wochenschrift, vol. 109, no. 46, 1979, pp. 1802-7.
Froesch ER, Blatter G, Candinas R, et al. [Progress and developments in insulin therapy]. Schweiz Med Wochenschr. 1979;109(46):1802-7.
Froesch, E. R., Blatter, G., Candinas, R., Süsstrunk, H., & Morell, B. (1979). [Progress and developments in insulin therapy]. Schweizerische Medizinische Wochenschrift, 109(46), 1802-7.
Froesch ER, et al. [Progress and Developments in Insulin Therapy]. Schweiz Med Wochenschr. 1979 Dec 1;109(46):1802-7. PubMed PMID: 515716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Progress and developments in insulin therapy]. AU - Froesch,E R, AU - Blatter,G, AU - Candinas,R, AU - Süsstrunk,H, AU - Morell,B, PY - 1979/12/1/pubmed PY - 1979/12/1/medline PY - 1979/12/1/entrez SP - 1802 EP - 7 JF - Schweizerische medizinische Wochenschrift JO - Schweiz Med Wochenschr VL - 109 IS - 46 N2 - BANTING and BEST revolutionized diabetes therapy with the discovery of insulin 57 years ago. Since then, progress in this area has been slow despite tremendous reseach efforts. The subcutaneous injection of a depot insulin does not provide optimal control of blood sugar. True progress has been brought about by intravenous insulin administration for the management of diabetic coma. The authors do not recommend ultra low dose therapy. The prognosis of diabetic coma is much better than 20 years ago, in particular because of much improved and continuous supervision of the circulation (CVP, ECG, K+ etc.). Pancreas and islet transplantation fail in man due to immunological rejection. The "artificial pancreas" with a glucose sensor is useful for research purposes, and for controlling blood sugar for a few days at most. The implantable glucose sensor is not yet in sight. The authors have treated diabetics successfully with a programmable flexible open loop infusion program. The basal insulin infusion rate can be varied from 0.25 to 2 U/h, and rectangular one hour extra insulin infusions between 2 and 10 U/h are superimposed by pushing a button on the steering unit. The pump automatically switches back to the basal rate after one hour. No hypoglycemic reactions have been observed in patients on ths program on the ward or at home. At present, technical problems with the catheter remain to be solved before this simple therapeutic approach can be applied routinely. SN - 0036-7672 UR - https://www.unboundmedicine.com/medline/citation/515716/[Progress_and_developments_in_insulin_therapy]_ DB - PRIME DP - Unbound Medicine ER -