Albisser A M, Botz C K, Leibel B S
Diabetologia. 1979 Feb;16(2):129-33. doi: 10.1007/BF01225463.
This study characterizes the glycaemic and insulin responses of a group of 5 anaesthetized dogs to a portal glucose infusion of 10 mg/kg/min before and after pancreatectomy. Insulin was administered intraportally to the pancreatectomized dogs according to a simple preprogrammed waveform composed of a constant basal rate of 0.35 +/- 0.02 mU/kg/min which was increased to 2.00 mU/kg/min at the time of the 60 minute glucose challenge. When this square waveform was applied the glycaemic response was similar to that seen in the normal controls in the baseline and challenge periods. Blood glucose concentration differed significantly (p less than 0.05) only from 20 to 100 minutes after the end of the challenge when it was higher by 20 +/- 1 mg/dl. Insulin levels were not significantly different from controls. It may be concluded that normoglycaemia and normoinsulinaemia can be maintained by a simple constant rate of portal insulin delivery while the blood glucose response to a glucose infusion can be ostensibly normalized without hyperinsulinaemia simply by enhancing insulin delivery during the challenge. The feasibility of this approach implies that with further development of the preprogrammed waveforms and with a greater understanding of their characteristics portable insulin delivery systems may be realized which accomodate more physiological challenges. The portal route for insulin delivery may however be necessary if peripheral hyperinsulinism is inappropriate.
本研究描述了一组5只麻醉犬在胰腺切除前后对以10mg/kg/min的速率门静脉输注葡萄糖时的血糖和胰岛素反应。根据一个简单的预编程波形，对胰腺切除的犬经门静脉给予胰岛素，该波形由0.35±0.02mU/kg/min的恒定基础速率组成，在60分钟葡萄糖激发试验时增加到2.00mU/kg/min。当应用这种方波时，在基线期和激发期的血糖反应与正常对照组相似。仅在激发试验结束后20至100分钟，血糖浓度有显著差异（p<0.05），此时血糖浓度高出20±1mg/dl。胰岛素水平与对照组无显著差异。可以得出结论，通过简单的恒定速率经门静脉输注胰岛素可以维持正常血糖和正常胰岛素血症，而在激发试验期间仅通过增加胰岛素输注量，在无高胰岛素血症的情况下，对葡萄糖输注的血糖反应表面上可以正常化。这种方法的可行性意味着，随着预编程波形的进一步发展以及对其特性的更深入了解，可能会实现能够应对更多生理挑战的便携式胰岛素输送系统。然而，如果外周高胰岛素血症不合适，经门静脉途径输送胰岛素可能是必要的。
