[Artificial pancreas: clinical and therapeutic value in 11 patients (author's transl)]

Abstract

Fluctuations in blood glucose levels which occur in the brittle diabetic explain the difficulty of blood glucose control by insulin therapy as used at the present time. The artificial endocrine pancreas is a bedside device capable of maintaining blood sugar value within a normal range by the administration of adequate amounts of insulin or glucose given at the optimal time. The glycemic control of 11 brittle diabetics is improved during the 5 days after a 24 hour connection with the AEP. A better determination of adequate subcutaneous doses of insulin, based on the circadian insulin profile infused by the artificial endocrine pancreas, achieved the improvement of glycemia. Glucagon profile preceeding, during and after AEP is also discussed. Using a method of two injections daily of a mixture acterapid and semi-lente, as a general rule it is found that approximately fifty per cent of the dose must be given in the acterapid form. Glucagon value decreases during the 24 h artificial endocrine pancreas. This is suggestive of a possible role of hyperglucagonemia in brittle diabetes.