Comparison of apolipoprotein B100 metabolism between continuous subcutaneous and intraperitoneal insulin therapy in type 1 diabetes.
OBJECTIVE
In type 1 diabetic patients, the replacement of s.c. insulin infusion with i.p. insulin infusion restores the normal physiological gradient between the portal vein and the peripheral circulation, which is likely to modify lipoprotein metabolism.


METHODS
To check this hypothesis, we performed two apolipoprotein (apo) B100 kinetic studies in seven type 1 diabetic patients, first under s.c. insulin infusion and then 3 months after the beginning of i.p. insulin infusion.


RESULTS
Glycemic control was similar under s.c. insulin infusion and i.p. insulin infusion, as assessed by glycated hemoglobin A1c and the capillary glycemic curve determined during the kinetic study. Very low-density and intermediate-density lipoprotein apoB100 pool size, production rate, and fractional catabolic rate (FCR) were similar under s.c. insulin infusion and i.p. insulin infusion. The low-density lipoprotein apoB100 FCR tended to decrease under ip insulin (0.45 +/- 0.06 vs. 0.55 +/- 0.11 pool/d), but the difference did not reach statistical significance (95% confidence interval for the difference, -0.33, 0.11). The low-density lipoprotein apoB100 pool size and production rate remained unchanged under i.p. insulin infusion compared with s.c. insulin infusion.


CONCLUSIONS
In type 1 diabetic patients, the replacement of s.c. insulin infusion with i.p. insulin infusion does not induce profound modifications of apoB100-containing lipoprotein production and FCRs.
Duvillard
Laurence
L
Institut National de la Santé et de la Recherche Médicale, Unité 498, Hôpital du Bocage, BP 77908, 21079 Dijon Cedex, France. laurence.duvillard@chu-dijon.fr
Florentin
Emmanuel
E
Baillot-Rudoni
Sabine
S
Lalanne-Mistrich
Marie-Laure
ML
Brun-Pacaud
Agnès
A
Petit
Jean-Michel
JM
Brun
Jean-Marcel
JM
Gambert
Philippe
P
Vergès
Bruno
B
D053299:Apolipoprotein B-100; D001055:Apolipoproteins B / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003198:Computer Simulation; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000378:metabolism*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007274:Injections, Intraperitoneal; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical
D053299:Apolipoprotein B-100; D001055:Apolipoproteins B; D001786:Blood Glucose; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D007004:Hypoglycemic Agents; D007328:Insulin