Free Insulin Profiles in Insulin-dependent Diabetics Treated with One or Two Insulin Injections per Day
- 24 April 2009
- journal article
- research article
- Published by Wiley in Acta Medica Scandinavica
- Vol. 220 (2), 133-141
- https://doi.org/10.1111/j.0954-6820.1986.tb02741.x
Abstract
Twenty-four hour profiles of free insulin and blood glucose were determined in 12 healthy controls and 10 insulin-dependent diabetics treated with insulin regimens based on intermediate-acting insulin injected subcutaneously once or twice a day. The diabetics were ambulatory and in a good glycemic control, i.e. without hyperglycemic symptoms or frequent hypoglycemias and with HbAl <9% (reference value 5.9-7.8%). Body weight was normal and median age (32 years) was the same in both groups. Free insulin was determined after polyethylene glycol precipitation of antibody-bound insulin. The controls had a low basal insulin level (median fasting value 3.9 mU/l) and postprandial peaks with a maximum within 30-60 min. There was no rise in plasma free insulin or blood glucose in the early morning hours. The free insulin profiles in the diabetics were highly unphysiological with hyperinsulinemia between the meals and during the night. The highest plasma free insulin value during the 24 hours was reached before lung (approximately 5-fold compared to normals, p < 0.01). Postprandially the free insulin concentrations did not reach the peak levels of the normals. After breakfast, blood glucose rose considerably in the diabetics (p < 0.02 compared to normals) while the rise after lunch and dinner was not higher than in the healthy controls. The difficulties in glycemic control in the diabetic group, i.e. a blood glucose rise after breakfast and hypoglycemias in some patients, could largely be explained by the unphysiological insulin profiles.Keywords
This publication has 22 references indexed in Scilit:
- Absorption kinetics and action profiles of mixtures of short-and intermediate-acting insulinsDiabetologia, 1984
- Fasting Early Morning Rise in Peripheral Insulin: Evidence of the Dawn Phenomenon in NondiabetesDiabetes Care, 1984
- Importance of Timing of Preprandial Subcutaneous Insulin Administration in the Management of Diabetes MellitusDiabetes Care, 1983
- The bioavailability of circulating antibody-bound insulin following insulin withdrawal in Type I (insulin-dependent) diabetesDiabetologia, 1983
- Comparison of single- and split-dose insulin regimens with 24-hour monitoringThe Journal of Pediatrics, 1981
- Control of Blood Sugar in Insulin-Dependent Diabetes: Comparison of an Artificial Endocrine Pancreas, Continuous Subcutaneous Insulin Infusion, and Intensified Conventional Insulin TherapyNew England Journal of Medicine, 1980
- Cyclic Oscillations of Basal Plasma Glucose and Insulin Concentrations in Human BeingsNew England Journal of Medicine, 1979
- complications of Diabetes Mellitus: Relationship to Metabolic DysfunctionDiabetes Care, 1979
- Serial Postprandial Plasma Insulin Levels in 117 Subjects With and Without DiabetesDiabetes, 1973
- A Simple Method for the Determination of Serum Free Insulin Levels in Insulin-treated PatientsDiabetes, 1973