Therapeutic Effect of Semisynthetic Human Insulin Administered with a Continuous Intravenous Infusion System
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To investigate the effects of semisynthetic human insulin in diabetic hyperglycemia, 11 diabetic patients with severe hyperglycemia were treated by the continuous intravenous infusion method using low-dose insulin, and the results were compared with those treated with porcine insulin. The plasma glucose HbA<SUB>1</SUB>, plasma inorganic phosphate (Pi), potassium (K), venous bicarbonate (HCO<SUB>3</SUB><SUP>-</SUP>) and 2, 3-diphosphoglycerate (2, 3-DPG) were determined in the initial and subsequent course of the treatment.<BR>The 11 patients included 7 with diabetic keto-acidosis (DKA), one with hyperglycemic hyperosmolar nonketotic coma and 3 with nonketotic hyperglycemia without consciousness disturbance. 5 patients administered semisynthetic human actrapid insulin (Novo) were defined as the A-HM group, and the remaining 6 patients administered actrapid or MC actrapid insulin (Novo) as the Porcine group. The results obtained were as follows.<BR>1) Before the treatment, the plasma glucose levels were 566±36 mg/d<I>l</I> (M±SE) in the A-HM group and 563±88 mg/d<I>l</I> in the Porcine group, and decreased rapidly until 3 hours after the onset of treatment.<BR>2) The insulin doses for the first 3 hours were 21±4 u in the A-HM group and 16±4 u inthe Porcine group, and they did not differ significantly.<BR>3) Although the rates of decrease of the plasma glucose level in the initial 3 hours were 86 ±18 mg/d<I>l</I> · hr in the A-HM group and 63±14 mg/dl· hr in the Porcine group, no significant difference was seen in both groups.<BR>4) Pi, K and HbA<SUB>1</SUB> decreased significantly after the onset of insulin treatment, and the responses of each of the parameters were identical in both insulin groups.<BR>5) In the 7 patients with DKA, the concentrations of HCO<SUB>3</SUB><SUP>-</SUP> and 2, 3-DPG were low before the treatment, and gradually increased after the treatment in both groups.<BR>Thus, in the treatment of severe hyperglycemic diabetics by the continuous intravenous insulin infusion method using a low dose, the potency of semisynthetic human insulin was indistinguishable form that of porcine insulin in the present clinical study.
- 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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