:Evaluadon of an Artificial Endocrine Pancreas and a Pre-programmable Insulin Infusion System
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Four "brittle" diabetic patients were given intravenous insulin infusion with our original artificial endocrine pancreas system and with a preprogrammable insulin infusion system, and subcutaneous insulin infusion with the latter system. Their blood glucose regulation as assessed from the mean blood glucose, M-value, mean amplitude of glycemic excursions, and frequency of occurrence of hypoglycemia was compared with that of conventional insulin therapies.<BR>1. The artificial endocrine pancreas which we developed originally, was capable of restoring the circadian blood glucose profile of brittle diabetics to within the physiological range without demonstrating hypoglycemia.<BR>2. Thereafter, one patient was given intravenous insulin infusion for 24 hr with a preprogrammable insulin infusion system. Insulin in an amount and in an infusion pattern corresponding to the daily insulin requirement determined with the artificial endocrine pancreas, was infused. By the intravenous infusion of insulin, near normal blood glucose fluctuations could be achieved in a brittle diabetic patient.<BR>3. Brittle diabetic patients were then treated by subcutaneous insulin infusion with the preprogrammable insulin infusion system at a constant basal rate supplemented with the pulse-dose exponential decrement mode at meal time. The insulin infusion amounts were 1.0 to 1.5 timesas much as the insulin determined with the artificial endocrine pancreas. However, the glycemic control expressed as MAGE was not improved and unpredictable swings in blood glucose were observed. The efficiency of the subcutaneous insulin infusion treatment inbrittle diabetic patients corresponded to that of subcutaneous treatment consisting of two dailyinjections of intermediate-acting insulin (Insulin Rapitard).<BR>The present findings suggest that, as compared to an intravenous route, subcutaneous insulin injections either by insulin infusion with a preprogrammable insulin infusion system or conventional therapies, may contribute to variability in insulin absorption and consequent lability of metabolic control. For better control and a more stable pattern of blood glucose in brittle diabetics with conventional insulin treatment, it is important to determine the appropriate doses for each type of insulin preparation on the basis of results obtained with the artificial endocrine pancreas system.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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