Insulin Administration and Rate of Glucose Appearance in People With Type 1 Diabetes
Insulin Administration and Rate of Glucose Appearance in People With Type 1 Diabetes
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DOI：
10.2337/dc08-0705
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发表时间：
2008-11-01
期刊：
影响因子：
16.2
通讯作者：
Dunger, David B.
中科院分区：
文献类型：
--
作者：
Pennant, Mary E.;Bluck, Leslie J. C.;Dunger, David B.
研究设计与方法：研究设计与方法：对6例成人(24+/-2岁)、瘦(BMI 23.6+/-1.5 kg/m(2))、控制良好的1型糖尿病(病程7.9+/-6.9年，A1C 7.6+/-0.9%)的1型糖尿病患者(病程7.9+/-6.9年，A1C 7.6+/-0.9%)进行了研究。在进餐前输注阿昔洛韦以维持正常血糖。受试者在不同的场合吃了两顿相同的食物，并使用双同位素方法测量了Ra-Meal。[6，6(-2)H(2)]葡萄糖加入膳食(0.081 g/kg体重)，预先恒速/变速输注[1，2，3，4，5，6，6-H-2(2)]葡萄糖。在餐前20分钟加服阿昔洛韦0.1U/kg体重。结果餐后胰岛素浓度显著高于基础胰岛素研究期间(119+/-1.6vs.66+/-1.5pmol/L，经配对t检验，P=0.03)。尽管胰岛素浓度不同，但总葡萄糖出现(3398+/-197比3,307+/-343 mU/kg)或总葡萄糖出现的25%(33.1+/-3.3比31.7+/-3.5分钟)、50%(54.6+/-3.5比54.1+/-4.7分钟)和75%(82.9+/-7.1比82.8+/-5.8分钟)的时间没有差异，基础日(73+/-8%)和膳食日(75+/-4%)循环中出现的葡萄糖剂量的比例是相同的。结论--这些结果表明，1型糖尿病患者的膳食中出现的葡萄糖与膳食中的胰岛素浓度无关。
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 (Ra-meal) was investigated in six adult (aged 24 +/- 2 years), lean (BMI 23.6 +/- 1.5 kg/m(2)) 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 Ra-meal was measured using a dual isotope method. [6,6(-2)H(2)]glucose 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-H-2(2)] glucose 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 +/- 1.6 vs. 66 +/- 1.5 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 mu mol/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.