|Reference : Prevention of metabolic alterations by insulin supplements administered either before or...|
|Scientific journals : Article|
|Human health sciences : Endocrinology, metabolism & nutrition|
|Prevention of metabolic alterations by insulin supplements administered either before or after 2-h nocturnal interruption of CSII.|
|Scheen, André [Université de Liège - ULg > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]|
|Henrivaux, P. [> > > >]|
|Jandrain, Bernard [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]|
|Paolisso, G. [> > > >]|
|Lefebvre, Pierre [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]|
|American Diabetes Association|
|Yes (verified by ORBi)|
|[en] Adult ; Blood Glucose/metabolism ; Diabetes Mellitus, Type 1/blood/drug therapy/metabolism ; Drug Administration Schedule ; Glucagon/blood ; Humans ; Injections, Subcutaneous ; Insulin/administration & dosage/blood/therapeutic use ; Insulin Infusion Systems|
|[en] To evaluate the efficacy of a bolus insulin injection to prevent the metabolic alterations induced by a 2-h nocturnal interruption of a continuous subcutaneous insulin infusion (CSII), nine type I (insulin-dependent) C-peptide-negative diabetic patients were studied from 2200 to 0800 h during two randomized tests. An insulin bolus (2.1 +/- 0.2 U) was administered via the pump either at 2300 h, just before CSII interruption, or at 0100 h, after reactivating the pump at its usual basal rate (1.05 +/- 0.11 U/h). The insulin bolus at 2300 h induced a significant rise in plasma free-insulin levels at 2400 h (+6.9 +/- 1.8 mU/L, P less than .01), resulting in an early and marked fall in blood glucose concentrations between 2300 and 0100 h (-2.7 +/- 0.5 mM, P less than .001), with hypoglycemic values in five patients. The insulin bolus at 0100 h counteracted the fall in plasma free-insulin levels observed between 2300 and 0100 h and significantly increased plasma insulin at 0200 h (+3.2 +/- 0.8 mU/L, P less than .01). Blood glucose concentrations that remained stable during the 2-h arrest of the pump fell significantly between 0100 and 0400 h (-2.1 +/- 0.5 mM, P less than .005). This fall rate was significantly lower than that measured within the 3 h after the insulin bolus given before CSII interruption but significantly higher than that observed in a reference control group of patients whose pump was functioning normally throughout the night.(ABSTRACT TRUNCATED AT 250 WORDS)|
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