[Glycosylated proteins and control of the diabetic: use of continuous flow insulin pumps by the subcutaneous route].

Ten insulin-dependent diabetic patients were controlled using a portable insulin pump (Pye Dynamic MS 16). They were studied for approximately 10 weeks. The responses of fasting blood glucose, glycosylated serum proteins and glycosylated hemoglobin were studied. Glycosylated serum proteins and glycosylated hemoglobin were measured a semi-automated colorimetric method. Although the fasting blood glucose decreased by about 45%, its variability underlines its limitation as a metabolic control parameter. Glycosylated hemoglobin decreased by 9% in the first week, and 21% by the tenth week. The glycosylated serum proteins decrease was 39% in the first week and 50% by the third week. Four insulin-dependent pregnant women had a similar but less rapid, decrease in the 3 variables compared to the other 6 cases. In all ten diabetics treatment lowered the 3 variables toward normal levels when compared to 73 insulin dependent diabetic patients using the classic method of daily insulin injections. The kinetic patterns of the 3 variables confirms the usefulness of glycosylated serum proteins which respond to altered levels of control more rapidly (10 days) than glycosylated hemoglobin. This is shown both by the response to improved control in insulin-dependent diabetics and secondly by their changes after insulinoma removal. The physiopathological significance of serum protein glycosylation is at present uncertain.