On the relationship between ketonuria and natriuresis during fasting and upon refeeding in obese patients.
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Biomedical subjects
Publications and source records attributed to A Bodson.
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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.
The diagnosis of insulinoma is easily done now but, in many cases, it is still difficult to locate it without the use of invasive procedures. With selective angiography and percutaneous transhepatic catheterization of the portal vein however, failure is reduced to about 4%. We report a case of a double localisation of insulinoma, revealed by an intraoperative catheterization of the splenic vein. The advantages of this method are discussed.