Changes in Basal Insulin Infusion Rates With Subcutaneous Insulin Infusion

Abstract

OBJECTIVEEvaluation of the time required until a change in the basal insulin infusion rate with an insulin pump induces subsequent changes in the metabolic effect.RESEARCH DESIGN AND METHODSIn this euglycemic glucose clamp study, 10 male subjects with type 1 diabetes received three different subcutaneous insulin infusion rates (0.5, 1.0, and 2.0 units/h; for 4 h each) of insulin lispro (IL) with insulin pumps.RESULTSAn increase in insulinemia occurred within 15–30 min after changing the infusion rate. While the serum IL levels reached a steady state at the end of the infusion period, the glucose infusion rates did not always reach steady-state levels with the higher infusion rates. However, an increase in the glucose consumption occurred within 30–60 min after switching the infusion rate.CONCLUSIONSSeveral hours are required until a new steady state in the metabolic effect is achieved after a significant change in basal insulin infusion.

Accuracy of a New Patch Pump Based on a Microelectromechanical System (MEMS) Compared to Other Commercially Available Insulin Pumps

“…Regarding the pharmacokinetics of rapid-acting analogues after subcutaneous infusion, doubling the basal rate from 1 IU/h to 2 IU/h has an effect on glucose infusion rates in euglycemic clamp starting only after 30-60 minutes. 16 Besides, in these adult male patients with normal insulin requirements (0.12 IU/kg), switching from 0.1 IU/h to 0.5 IU/h for 4 hours did not change the glucose infusion rate. However, the situation may be different in patients with very high insulin sensitivity or low insulin requirements (like children).…”

Explorative Study of Pharmacokinetics and Pharmacodynamics after Change in Basal Insulin Infusion Rate

“…7 Our infusion rate was 1.6 ± 0.6 IU/h (mean ± SD), with a dose range of 0. In evaluation of the clearance results, it must be kept in mind that the model used for clearance calculation [X(t) = α + β(1 -exp(-γt)] is an approximation.…”

Dynamic Insulin on Board: Incorporation of Circadian Insulin Sensitivity Variation

“…This equation also describes the penalty curve, which is identical except for the insertion of anticipatory time-shift D. In this work, D was set to 1 h in order to take into account delays associated with subcutaneous insulin delivery and insulin pharmacokinetics and pharmacodynamics. 3 The static decay curves currently used in different bolus calculators can be adapted based on the time-dependent penalty factor described by this function. At any point that a standard decay curve would be consulted to evaluate IOB and inform a dosage decision, an improved IOB curve that accounts for that time of day can be found by multiplying the standard curve by the penalty factor.…”

“…2,3 Circadian rhythms affect insulin sensitivity but, by contrast, are relatively consistent from day to day and within populations. 4 For example, the glucose tolerance of people without diabetes tends to be optimal in the morning and decline during the day, whereas people with T1DM typically require more insulin per gram of carbohydrate at breakfast compared with other meals, due to morning increases in insulin resistance.…”