One to Five Days of Continuous Intravenous Insulin Infusion on Seven Diabetic Patients

Abstract

Regular insulin was infused from one to five days in seven adult diabetic volunteers previously treated with subcutaneous insulin three times a day. Through a catheter inserted in a peripheral vein, a small pump delivered 66 ± 10 units of insulin per day in a 131.0 ± 4.0 ml. solution at mean rates of 26 ± 4 mU./min. between meals and 373 ± 58 mU/min. during meals; 40 per cent of the total daily dose was given during the three meal periods. These rates were precalculated. Patients were ambulatory. Blood glucose was assayed every fifteen minutes for eight hours during the postprandial periods and hourly otherwise. The over-all highest mean values were observed ninety minutes after breakfast (138 ± 17 mg./100 ml.) and four hours after dinner (121 ± 18); the lowest were 73 ± 7, 64 ± 7, 72 ± 15 at the end of the three high concentration insulin infusion periods and 56 ± 7 at 6 a.m. During insulin infusions the mean values of blood glucose parameters were as follows: 89 ± 7 mg./100 ml. for the mean blood glucose level; 66 ± 9 for the mean amplitude of glycemic excursion; and 17 ± 5 for the modified Schlichtkrull's M coefficient. Insulin infusions gave significantly lower blood glucose levels during the night and at breakfast than insulin three times a day, and higher blood glucose values before lunch. Both technics gave very good control of diabetes. Insulin infusions without blood glucose monitoring are feasible for several days in ambulatory patients.

The metabolic and hormonal responses to a mixed meal in umestrained pancreatectomised dogs chronically treated by portal or peripheral insulin infusion

“…Similar open-loop studies but of shorter duration (1-9 weeks) on insulin dependent diabetic patients have been reported with peripheral intravenous [4][5][6][7] and subcutaneous [8] insulin infusions. With peripherally infused insulin, such ideal blood glucose control is achieved only with a concomitant peripheral hyperinsulinaemia achieved either systemically [9] or locally [10] at the site of subcutaneous infusion.…”

Insulinpumpentherapie 2010

“…Die Geschichte der CSII von Kadish (1963;[24]), über Hepp (1966;[20]), Slama (1974;[54]), Pickup (1978; [39]) u. a. ist ausführlich beschrieben [17].…”

Continuous Subcutaneous Insulin Infusion—An Historical Perspective

“…14,15 Meanwhile, several classical studies were being done with continuous intravenous insulin delivery in an attempt to mimic normal physiology. [16][17][18][19] Development of methods for continuous glucose measurement permitted this to be combined with intravenous insulin infusion to develop glucose-controlled insulin infusion systems (GCIIS). This was first attempted by Arnold Kadish in Beverly Hills, CA in the 1960s.…”