Abstract
A marked improvement of blood glucose control has recently been achieved with the use of a portable infusion pump.
To improve blood glucose control in diabetic patients by continuous subcutaneous insulin infusion (CSII), we studied 13 insulin dependent diabetic patients (including two pancreatectomized patients and one unstable diabetic patient). The basal infusion rate was adjusted so as to normalize the fasting blood glucose (FBS) levels, and thereafter a pulse dose before meals was added in six insulin dependent diabetic patients. In this manner, near-normalization of the blood glucose levels was achieved throughout the day safely, smoothly and simply. To assess the day-to-day fluctuations in basal IRI and FBS levels by CSII therapy, we compared CSII with conventional insulin injection (depot injection) by measuring the fasting IRI and FBS for 5 days. Both the fluctuations of IRI and FBS in CSII therapy were less than those in conventional insulin injection therapy. On comparison of the pulse dose, there were no significant changes in the IRI and blood glucose levels between bolus injection and square wave injection.
We also applied CSII therapy to the two total pancreatectomized patients and unstable diabetic patient. In the former, near-normalization of the blood glucose levels was achieved, but in the latter, it was not, in spite of a reduction of urine acetone bodies, urine sugar and hypoglycemic attacks.
In conclusion, it can be said the CSII system might provide a more feasible means for diabetic control than conventional insulin therapy.
