Kraegen E W, Chisholm D J, McNamara M E
Horm Metab Res. 1981 Jul;13(7):365-7. doi: 10.1055/s-2007-1019271.
In non-diabetics neural and/or gastrointestinal humoral factors cause anticipatory insulin release with meals. The importance of this mechanism was illustrated by administration of a standard meal to six insulin dependent diabetics on two occasions. Insulin was delivered intravenously by an "open-loop" (preprogrammed) insulin infusion system designed to simulate the normal insulin response to meals. On one occasion insulin delivery was delayed 15 minutes. This time approximates the physiology delay before blood glucose rises after the start of a meal. The delay resulted in significantly greater hyperglycaemia continuing over three hours, compared with the study in which insulin delivery increased coincident with the start of the meal. A mechanism for initiating early insulin release with meals would be a helpful addition to "closed-loop" insulin delivery systems, this being apparent in a further comparison made between performance of the open-loop and closed-loop systems. Moreover, the delayed insulin response seen in maturity onset diabetics is likely to be an important cause of persistent hyperglycaemia.
在非糖尿病患者中，神经和/或胃肠体液因素会引起进餐时的预期性胰岛素释放。给6名胰岛素依赖型糖尿病患者分两次提供标准餐，说明了这一机制的重要性。胰岛素通过一个“开环”（预编程）胰岛素输注系统静脉输注，该系统旨在模拟正常的进餐时胰岛素反应。其中一次胰岛素输注延迟了15分钟。这段时间接近进餐开始后血糖升高前的生理延迟时间。与胰岛素输注在进餐开始时同步增加的研究相比，这种延迟导致三小时内的高血糖明显更严重。对于“闭环”胰岛素输送系统而言，一种用于启动进餐时早期胰岛素释放的机制将是一个有益的补充，这在对开环和闭环系统性能的进一步比较中很明显。此外，成年型糖尿病患者中出现的胰岛素反应延迟可能是持续性高血糖的一个重要原因。
