Vague P, Moulin J P, Souid J, Lassmann V, Vialettes B
Diabete Metab. 1983 Dec;9(4):288-91.
Programming open loop insulin delivery systems makes necessary the knowledge of patients insulin needs. It is frequently postulated that insulin needs increase at the end of the night in relation to the rise in cortisol secretion. According to this hypothesis is it justified to speed up the insulin infusion rate in the early morning? This question was addressed by studying insulin infusion rate by an artificial pancreas during the night in 12 C. peptide negative insulin dependent diabetics. They were connected to the artificial pancreas from 8 a.m. to 10 a.m. the next morning while on their habitual diabetic diet and slept as usual from 11 p.m. to 7 a.m. approximately. From 11 p.m. to 7 a.m. mean insulin infusion rate was 21.5 +/- 3.3 mU/Kg/h representing 15.6 +/- 1.6% of the dose delivered in 24 hours. Blood glucose was stable around 85 mg/dl. No significant differences were observed in the hourly insulin infusion rate during the night period, in spite of a slight tendency to a rise (from 21.1 +/- 2.8 to 22.1 +/- 2.6 mU/kg/h) tendency to a rise (from 21.1 +/- 2.8 to 22.1 +/- 2.6 mU/kg/h) after 4 a.m. On the basis of these results obtained in patients sleeping as usual it does not appear useful to envisage a systematic acceleration of insulin infusion rate by continuous delivery systems in the early morning.
对开环胰岛素输送系统进行编程需要了解患者的胰岛素需求。人们常常假定，夜间胰岛素需求会随着皮质醇分泌的增加而上升。根据这一假设，清晨加快胰岛素输注速率是否合理呢？为解决这个问题，研究人员对12名C肽阴性胰岛素依赖型糖尿病患者在夜间使用人工胰腺时的胰岛素输注速率进行了研究。他们从上午8点至次日上午10点连接到人工胰腺，期间保持惯常的糖尿病饮食，并于晚上11点至早上7点左右正常睡眠。从晚上11点至早上7点，平均胰岛素输注速率为21.5±3.3 mU/Kg/小时，占24小时输送剂量的15.6±1.6%。血糖稳定在85mg/dl左右。尽管凌晨4点后胰岛素输注速率有轻微上升趋势（从21.1±2.8升至22.1±2.6 mU/kg/小时），但夜间每小时胰岛素输注速率并无显著差异。基于这些在正常睡眠患者中获得的结果，似乎没有必要设想通过连续输送系统在清晨系统性地加快胰岛素输注速率。
