Lilet H, Krzentowski G, Bodson A, Scheen A J, Lefebvre P J
Service de Diabétologie, Hôpital civil de Jumet, Belgique.
Diabete Metab. 1991 May-Jun;17(3):363-72.
Our study is based on two constatations: 1) Hyperinsulinaemia, a possible atherogenic factor, is frequent under continuous subcutaneous insulin infusion. 2) Pulsatile intravenous insulin delivery improve the insulin's hypoglycaemic activity. To test if equivalent metabolic control can be obtained with a reduced intermittent subcutaneous infused insulin dose, we compared nocturnal metabolic control of 8 c-peptide negative type 1 diabetic patients under three experimental conditions: Continuous usual dose test (1.0 +/- 0.1 u/h); Intermittent half dose test (1.0 +/- 0.1 u/h, 30 min/h); Continuous half dose test (0.5 +/- 0.05 u/h) Five parameters were monitored: blood glucose, plasma free insulin and beta-hydroxy-butyrate, free fatty acid and glycerol plasma level. No significant differences were found between intermittent and continuous half-dose tests. We conclude that, in our experimental conditions, intermittent subcutaneous insulin infusion does not reduce the metabolic degradation induced by insulin dose reduction.
1）高胰岛素血症是一种可能的致动脉粥样硬化因素，在持续皮下胰岛素输注时很常见。2）脉冲式静脉注射胰岛素可改善胰岛素的降血糖活性。为了测试减少间歇性皮下注射胰岛素剂量是否能获得等效的代谢控制，我们比较了8例C肽阴性1型糖尿病患者在三种实验条件下的夜间代谢控制情况：持续常规剂量测试（1.0±0.1单位/小时）；间歇性半剂量测试（1.0±0.1单位/小时，每小时30分钟）；持续半剂量测试（0.5±0.05单位/小时）。监测了五个参数：血糖、血浆游离胰岛素和β-羟基丁酸、游离脂肪酸和甘油血浆水平。间歇性和持续半剂量测试之间未发现显著差异。我们得出结论，在我们的实验条件下，间歇性皮下胰岛素输注不会减少胰岛素剂量减少所引起的代谢降解。
