Development and application of insulin infusion profiles for therapy of type I diabetics with portable insulin infusion systems

Abstract

The metabolism of insuIin-dependent diabetics (lDDs) cannot always be normalized by the conventional subcutaneous insulin regimen that usually provides only two Injections of reguIar and intermediate-acting insulin per day, but glucose-controlled intravenous insuIin infusion ensures almost normal glycaemia all day long. However, glucose-controlled insulin infusion systems (GCIIS) are available only for inpatient treatment because, at present, in vivo glucose measuring systems are not suitable for portable devices. Thus only open-loop devices are considered for outpatient treatment for brittle IDDs. There is no difficulty in findIng the right dosage for the basic insulin requirement, but control of the postprandial blood glucose increase presents a greater problem since the preprandial blood glucose level should be restored within two hours postprandially, without rlsking severe hypo- or hyperglycaemia. It Is obvious that insulin dosage alone is insufficient for this, but the timing of the insulin infusion may be important. The aim of this study was to clarify the importance of different insulin infusion profiles on daily and postprandial blood glucose levels.