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At least 55 records · Page 3Linked to original sources
PubMed1980

24-hour blood glucose profiles in insulin-dependent diabetics treated with intravenous insulin infusion systems. A comparison between closed- and open-loop systems.

The aim of this study was to compare the 24-hour blood glucose profiles of insulin-dependent diabetics during treatment with preprogramed insulin delivery systems with those of patients on treatment with the artificial beta cell (Biostator). Mean blood glucose (MGB) was 4.4 +/- 0.5 mmol/l for 15 controls, 5.8 +/- 1.0 for 53 patients on open-loop and 6.0 +/- 0.6 for 20 patients on closed-loop treatment. MBG was significantly higher in diabetics than in non-diabetic, but the difference between the two diabetic populations was not significant. Mean amplitude of blood glucose excursion was 1.8 +/- 0.6, 4.3 +/- 1.3 and 3.5 +/- 0.8 mmol/l respectively, the difference between the diabetic groups being significant. No hypoglycemia was seen in patients during closed-loop treatment, whereas this was the case in 10 of 53 patients on treatment with open-loop systems. Physical exercise resulted in small but normal decreases in blood glucose without hypoglycemia. Plasma insulin was within the normal range during both regimes. It is concluded that blood glucose control during treatment with closed-loop system is superior to that during treatment with open-loop systems. However, under standard conditions i.v. insulin infusion with preprogramed pump devices resulted in blood glucose fluctuations comparable with those during Biostator treatment.

Adolescent↗
PubMed1986

Diabetes mellitus and open heart surgery. A simple, practical closed-loop insulin infusion system for blood glucose control.

A method, based on bedside determinations of blood glucose by nursing staff, was designed to control the administration of insulin to diabetic patients during and following open heart surgery. A computer-controlled intravenous infusion pump was used to deliver the insulin. Excellent control of the hyperglycaemia normally associated with open heart surgery was achieved, with 84 percent of measured blood glucose values falling within 2 mmol/litre of the target value of 6 mmol/litre. The method proved to be simple, effective, and safe.

Adult↗
PubMed1984

The response of blood intermediary metabolite levels to 24 hours treatment with a blood glucose-controlled insulin infusion system in type 1 diabetes.

Blood intermediary metabolite and hormone concentrations have been assessed in 10 insulin-dependent diabetic patients on SC injection therapy and during 24 hr of relative normoglycaemia on an artificial pancreas (GCIIS). Mean blood lactate (0.96 +/- 0.07 mmol/l) and pyruvate (0.087 +/- 0.004 mmol/l) levels remained elevated compared to normal controls (0.76 +/- 0.04 and 0.064 +/- 0.003, p less than 0.05 and less than 0.001, respectively). No tendency was detected for these levels to regress towards normal over the 24 hr period on the GCIIS. Mean individual 24 hr blood lactate concentrations correlated significantly with mean free insulin levels (r = 0.85, p less than 0.002), but inversely with prior out-patient diabetic control (r = 0.64, p less than 0.05). The shape of the 24 hr profiles of blood lactate and pyruvate changed between SC therapy and the GCIIS, corresponding in both studies to the form of the free insulin profile. Blood alanine and glycerol profiles were not abnormal on either regime. Blood 3-hydroxybutyrate levels were abnormal on both SC therapy (0.16 1.14 mmol/l) and the GCIIS (0.15 1.20 mmol/l, controls 0.04 1.31 mmol/l), with concentrations on SC therapy correlating positively with previous control. Abnormalities of intermediary metabolite levels persist during feedback normalization of blood glucose levels, with evidence of influences from both prior diabetic control, and current insulin delivery.

3-Hydroxybutyric Acid↗
PubMed1981

Brittle diabetes: long-term control with a portable, continuous, intravenous insulin infusion system.

A young woman had severe brittle diabetes mellitus that was critically unmanageable with all conventional insulin treatment. Continuous subcutaneous and intramuscular infusions of insulin also failed to control her metabolic instability. Use of a continuous intravenous infusion, however, whereby a portable, variable-rate, battery-operated syringe pump delivered insulin through a subcutaneously tunnelled central venous catheter, resulted in good control. When she was receiving hourly intramuscular insulin injections (a mean of 778 IU daily) mean blood glucose concentrations had been 22.1 +/- 1.4 mmol/l (398 +/- 25 mg/100 microliters). After she had received the intravenous infusion for one month as an outpatient mean blood glucose concentration was 8.2 +/- 0.46 mmol/l (148 +/- 8 mg/100 microliters) and only 80 IU insulin daily was required. Follow-up after over five months of use showed that few complications had occurred. The system is simple to use and safe, and the diabetes had been stabilised such that she could enjoy a near-normal life style.

Adult↗
PubMed1979

Optimal blood sugar control in labile diabetics using a portable open-loop insulin infusion system with a flexible program.

11 labile diabetics were well controlled after 2 days of an i.v., open-loop insulin infusion program consisting of constant, empirically determined, basal infusion rates (mean: 1.1 U/h) and superimposed rectangular one-hour insulin infusions between 2 and 8 U/h during the main meals. The steering unit switches automatically back to the basal infusion rate after one hour. An almost optimal blood sugar profile was already obtained on the third day of the infusion program. We believe that such a flexible, open-loop insulin infusion program would render long-term optimal blood sugar control in "labile" diabetics possible if the technological development ever allows implantation of the infusion pumps.

Adolescent↗
PubMed1976

Comparison of peripheral and portal routes of insulin infusion by a computer-controlled insulin infusion system (artificial endocrine pancreas).

This study was undertaken to determine the different consequences of portal and peripheral routes of insulin administration by the artificial endocrine pancreas. Intraportal glucose was infused (10 mg./min./kg. for 60 minutes) in anesthetized normal and pancreatectomized dogs while blood glucose concentrations were monitored continuously. During computer-controlled insulin administration normal glucose tolerance was restored by both portal and peripheral routes of insulin delivery. There were also no significant differences in (1) glycemic patterns, (2) insulin infusion patterns, (3) peripheral IRI levels, and (4) total insulin requirements between the two routes. It is apparent that the peripheral route, which is more readily accessible than the portal route, may be an appropriate infusion site for an implantable or portable prosthesis for controlling blood glucose concentration.

Animals↗
PubMed1979

A portable, pre-programmable insulin infusion system in diabetes mellitus.

A miniaturized portable pump has been developed in order to study the effects of pre-programmed insulin infusion patterns on the blood glucose levels in juvenile-onset, insulin-requiring diabetics. Six diabetics undergoing 7 insulin infusion periods of up to 4 days were studied. The mean blood glucose was 7.0 +/- 2.3 (SD) mmol/l and the mean amplitude of glycemic excursions was 5.0 +/- 1.4 mmol/l. Success in achieving normoglycemia will depend on choosing the correct dose of insulin for infusion.

Adult↗