Akademska digitalna zbirka SLovenije - logo
E-viri
Recenzirano Odprti dostop
  • Insulin Administration and ...
    Pennant, Mary E; Bluck, Leslie J.C; Marcovecchio, M. Loredana; Salgin, Burak; Hovorka, Roman; Dunger, David B

    Diabetes care, 11/2008, Letnik: 31, Številka: 11
    Journal Article

    OBJECTIVE:--To assess whether prandial insulin, in addition to basal insulin, has an effect on the rate of glucose appearance from a meal in people with type 1 diabetes. RESEARCH DESIGN AND METHODS--The rate of glucose appearance from a mixed meal (Rameal) was investigated in six adult (aged 24 ± 2 years), lean (BMI 23.6 ± 1.5 kg/m²) subjects with well-controlled type 1 diabetes (duration 7.9 ± 6.9 years, A1C 7.6 ± 0.9%) with/without prandial insulin. Actrapid was infused to maintain euglycemia before meals were consumed. Subjects consumed two identical meals on separate occasions, and Rameal was measured using a dual isotope method. 6,6-²H₂glucose was incorporated into the meal (0.081 g/kg body wt), and a primed constant/variable rate infusion of 1,2,3,4,5,6,6-²H₂glucose was administered. In the tests with prandial insulin, an additional bolus dose of Actrapid was given 20 min before the meal at 0.1 units/kg body wt. RESULTS:--Insulin concentration with prandial insulin was significantly higher than during basal insulin studies (119 ± 16 vs. 66 ± 15 pmol/l, P = 0.03 by paired t test). Despite differences in insulin concentration, there were no differences in total glucose appearance (3,398 ± 197 vs. 3,307 ± 343 μmol/kg) or time taken for 25% (33.1 ± 3.3 vs. 31.7 ± 3.5 min), 50% (54.6 ± 3.5 vs. 54.1 ± 4.7 min), and 75% (82.9 ± 7.1 vs. 82.8 ± 5.8 min) of total glucose appearance. The fraction of the glucose dose appearing in the circulation was the same for basal (73 ± 8%) and prandial (75 ± 4%) study days. CONCLUSIONS:--These results suggest that meal glucose appearance is independent of prandial insulin concentration in people with type 1 diabetes.