The use of the artificial pancreas in uremic diabetic patients.
Maintenance hemodialysis and renal transplantation are increasingly used for treating diabetic patients with end-stage renal failure. The use of the artificial pancreas is able to prevent large blood glucose fluctuations in these patients with atherosclerosis, advanced retinopathy or neuropathy in which hyper- and hypoglycemia are potentially deleterious. For this purpose, we have developed and are utilizing an artificial pancreas easily utilizable without special training by the staff of a dialysis unit. This artificial pancreas uses a polarographic glucose electrode with a fast response time (45 to 90 seconds), a terminal display for operator communication, and a continuous digital and analogyl display for control of the running operation. There is also a printer to display in tabular and graphical form the values at any time during the operation. In this preliminary study, 7 patients have been studied: five under repetitive hemodialysis for four hours, 3 times a week; one treated by peritoneal dialysis for 12 hours, twice a week and one controlled during, and 48 hours after, renal transplantation. The macroscopic pancreas normalizes blood glucose under these circumstances, helps in a better understanding of blood glucose homeostasis in uremic patients under dialysis, leads to a more precise evaluation of insulin needs, may help to improve the nutritional status of the patients, and has an educational value for the patient and the medical staff.
D001187:Artificial Organs; D001786:Blood Glucose / Q000032:analysis; D003201:Computers; D003928:Diabetic Nephropathies / Q000628:therapy*; D006801:Humans; D007263:Infusions, Parenteral / Q000295:instrumentation / Q000379:methods; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007515:Islets of Langerhans / Q000378:metabolism*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D008433:Mathematics; D006435:Renal Dialysis; D014184:Transplantation, Homologous; D014511:Uremia / Q000150:complications / Q000628:therapy*
D001786:Blood Glucose; D007328:Insulin