Chronic intermittent intravenous insulin therapy: a new frontier in diabetes therapy.
Chronic intermittent intravenous insulin therapy: a new frontier in diabetes therapy.
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DOI：
10.1089/152091501750220073
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发表时间：
2001-01-01
影响因子：
5.4
通讯作者：
Ahn, J H
中科院分区：
文献类型：
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作者：
Aoki, T T;Grecu, E O;Ahn, J H
常规胰岛素治疗在控制糖尿病及其并发症方面取得的有限成功表明需要重新评估胰岛素给药方案的适当性。实际上，常规皮下胰岛素给药产生缓慢变化的血液胰岛素水平和次优的肝细胞胰岛素化，导致肝脏处理进入的饮食葡萄糖的能力受损。胰岛素给药的新方法称为慢性间歇性静脉内胰岛素治疗（CIIIT），以脉动方式输送胰岛素，并在门静脉中达到生理胰岛素浓度。作为每周一次的门诊程序与每日强化皮下胰岛素治疗相结合，该程序已被证明（1）显著改善血糖控制，同时降低低血糖事件的发生率，（2）改善高血压控制，（3）减缓明显的糖尿病肾病的进展，以及（4）逆转糖尿病自主神经病变的一些表现（例如，异常昼夜血压模式、严重体位性低血压和低血糖无意识）。
The limited success achieved in controlling diabetes and its complications with conventional insulin therapy suggests the need for reevaluation of the appropriateness of insulin administration protocols. Indeed, conventional subcutaneous insulin administration produces slowly changing blood insulin levels and suboptimal hepatocyte insulinization resulting in impaired hepatic capacity for processing incoming dietary glucose. The novel approach to insulin administration known as chronic intermittent intravenous insulin therapy (CIIIT) delivers insulin in a pulsatile fashion and achieves physiological insulin concentration in the portal vein. Done as a weekly outpatient procedure combined with daily intensive subcutaneous insulin therapy, this procedure has been shown to (1) significantly improve glycemic control while decreasing the incidence of hypoglycemic events, (2) improve hypertension control, (3) slow the progression of overt diabetic nephropathy, and (4) reverse some manifestations of diabetic autonomic neuropathy (e.g., abnormal circadian blood pressure pattern, severe postural hypotension, and hypoglycemia unawareness).