Patterns of hyperinsulinaemia in type 1 diabetic patients with and without nephropathy.
The prevalence and patterns of insulinaemia in five groups of patients with Type 1 diabetes have been reinvestigated using a free insulin assay which minimizes in vitro redistribution of the free and antibody-bound insulin components. In 18 diabetic patients managed by conventional insulin injection treatment and 19 patients treated by continuous subcutaneous insulin infusion (CSII), the mean 24-h serum free insulin level exceeded a non-diabetic reference range in 78% (injections) and 68% (CSII). Twenty-four-hour profiles showed that hyperinsulinaemia occurred in the basal state before meals and at night, but not immediately post-prandially. The serum free insulin concentration at 0800 h, 1200 h, and 1600 h was significantly (p less than 0.001) correlated with mean 24-h free insulin in injection-treated and CSII patients, and samples at one of these time-points may thus provide a simple, single measure of integrated insulinaemia for population studies. There was no significant difference in 24-h mean free insulin levels in 7 patients randomly crossed-over between injection treatment and CSII, but the profiles had a more physiological pattern during CSII, with a mean post-prandial serum free insulin level which was significantly higher on CSII than injections (mean +/- SE = 37.2 +/- 3.1 vs 26.9 +/- 2.5 mU l-1, p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Pickup
J C
JC
Division of Chemical Pathology, United Medical School, Guy's Hospital, London, UK.
Collins
A C
AC
Walker
J D
JD
Viberti
G C
GC
Pasic
J
J
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications* / Q000652:urine; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000150:complications*; D007328:Insulin / Q000097:blood; D008297:Male; D011507:Proteinuria
D007328:Insulin