No full text
Article (Scientific journals)
Metabolic alterations after a two-hour nocturnal interruption of a continuous subcutaneous insulin infusion.
Scheen, André; Castillo, M.; Jandrain, Bernard et al.
1984In Diabetes Care, 7 (4), p. 338-42
Peer Reviewed verified by ORBi
 

Files


Full Text
No document available.

Send to



Details



Keywords :
3-Hydroxybutyric Acid; Adult; Alanine/blood; Blood Glucose/metabolism; C-Peptide/blood; Diabetes Mellitus, Type 1/blood/drug therapy; Drug Administration Schedule; Fatty Acids, Nonesterified/blood; Female; Glucagon/blood; Glycerol/blood; Humans; Hydroxybutyrates/blood; Insulin/blood; Insulin Infusion Systems; Male; Middle Aged
Abstract :
[en] In order to evaluate the metabolic consequences of a 2-h nocturnal interruption of continuous subcutaneous insulin infusion (CSII), seven insulin-dependent diabetic patients without residual insulin secretion were investigated. The changes in blood glucose, plasma free insulin, glucagon, free fatty acids, and 3-hydroxybutyrate (3 OH-B) concentrations have been compared during two randomized tests carried out either during the normal functioning of a Mill-Hill pump from 10 p.m. to 8 a.m. (1.00 +/- 0.06 U insulin/h, keeping adequate metabolic control) or during the same conditions but with a deliberate arrest of the pump between 11 p.m. and 1 a.m. Considering the value recorded at 11 p.m. as reference, interruption of the insulin infusion resulted in: (1) a rapid (already significant after 1 h) and sustained (maximal fall: --12.5 +/- 2.5 mU/L at 3 a.m.) decrease in plasma free insulin; (2) a delayed (significant after 4 h) and linear rise in blood glucose (maximal increase: + 4.0 +/- 1.3 mmol/L at 5 a.m.); (3) an early (significant at midnight) and prolonged rise in plasma free fatty acids (+ 387 +/- 148 mumol/L at 3 a.m.); (4) a delayed (significant after 3 h) and sustained increase in plasma 3 OH-B (+ 347 +/- 88 mumol/L at 3 a.m.); and (5) no significant changes in plasma glucagon. Thus, a 2-h interruption of CSII in resting nocturnal conditions is sufficient to induce significant, delayed, and sustained metabolic alterations in C-peptide-negative patients despite good baseline blood glucose control. Resetting the pump at its basal rate is insufficient to quickly restore adequate circulating insulin levels and effectively counteract the metabolic disturbances. The efficacy of a bolus insulin injection in these conditions should be evaluated.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Scheen, André  ;  Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale
Castillo, M.
Jandrain, Bernard ;  Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Krzentowski, G.
Henrivaux, P.
Luyckx, A. S.
Lefebvre, Pierre ;  Centre Hospitalier Universitaire de Liège - CHU > Diabétologie,nutrition, maladies métaboliques
Language :
English
Title :
Metabolic alterations after a two-hour nocturnal interruption of a continuous subcutaneous insulin infusion.
Publication date :
1984
Journal title :
Diabetes Care
ISSN :
0149-5992
eISSN :
1935-5548
Publisher :
American Diabetes Association, Alexandria, United States - Virginia
Volume :
7
Issue :
4
Pages :
338-42
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 08 June 2009

Statistics


Number of views
52 (0 by ULiège)
Number of downloads
0 (0 by ULiège)

Scopus citations®
 
19
Scopus citations®
without self-citations
16
OpenCitations
 
14

Bibliography


Similar publications



Contact ORBi