title: Pulsatile insulin infusion and glucose-homeostasis in well-controlled type 1 (insulin-dependent) diabetic patients.
abstract: Pulsatile, intravenous insulin infusion designed to mimic the portal insulin concentrations that emerge physiologically after a meal, has been postulated to improve glucose tolerance in Type 1 (insulin-dependent) diabetic patients. We studied the effects of insulin pulsing (10 i.v. pulses of human insulin of 0.035 U kg-1 idealised body weight were given, each of 20 s duration, with intervals of 6 min, three times per day covered with adequate administration of glucose) on 2 successive days on glucose-tolerance in nine well-controlled Type 1 diabetic patients on continuous subcutaneous insulin infusion therapy (age 26 (7) years, mean (SD); duration of diabetes 10 (7) years; body mass index 23.4 (2.3) kg m-2; HbA1c 6.0 (0.6)%). On the days before and after the insulin pulsing, the patients were subjected to metabolic assessments by an oral glucose tolerance test (1 g glucose kg-1 body weight) 30 min after the subcutaneous injection of 0.15 U kg-1 body weight regular human insulin and a subsequent bicycle-ergometer test. During these metabolic assessments, plasma free insulin concentrations, plasma glucagon and the non-protein respiratory quotient remained unaffected by the insulin pulsing. However, glucose tolerance deteriorated significantly (maximal glucose concentration 120 min after glucose load was 10.0 mmol l-1 before and 13.9 mmol l-1 after insulin pulsing, P less than 0.01). In conclusion, the pattern of insulin pulsing used in this study did not ameliorate oral glucose homeostasis in well-controlled Type 1 (insulin dependent) diabetic patients.
authors.affiliation: Department of Nutrition and Metabolic Diseases, Heinrich-Heine University of Düsseldorf, West Germany.
authors.forename: L
authors.initials: L
authors.lastname: Heinemann
authors.forename: G E
authors.initials: GE
authors.lastname: Sonnenberg
authors.forename: A
authors.initials: A
authors.lastname: Hohmann
authors.forename: A
authors.initials: A
authors.lastname: Ritzenhoff
authors.forename: M
authors.initials: M
authors.lastname: Berger
authors.forename: J
authors.initials: J
authors.lastname: Benn
authors.forename: P
authors.initials: P
authors.lastname: Sönksen
authors.forename: D
authors.initials: D
authors.lastname: Kelley
authors.forename: J
authors.initials: J
authors.lastname: Gerich
authors.forename: T
authors.initials: T
authors.lastname: Aoki
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005080:Exercise Test; D005260:Female; D005934:Glucagon / Q000097:blood; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood; D007332:Insulin Infusion Systems; D008297:Male; D011673:Pulsatile Flow
chemical_list: D001786:Blood Glucose; D007328:Insulin; D005934:Glucagon