[Improvement in the treatment of diabetes by means of a portable insulin-infusion apparatus. Preliminary results in 4 unstable juvenile diabetics]

Abstract

Four type 1 diabetics, 10 to 21 years after onset of diabetes and with no detectable levels of plasma C-peptide, were kept on intravenous insulin for 4 months by a portable open-loop insulin infusion system (Siemens, Germany). Using this system, a constant basal rate of insulin was continuously infused into the superior vena cava. During meals additional insulin was delivered for one hour. The patients went home after a few days on the ward, during which time the doses of insulin (basal and extra rates) were established. All four patients maintained the same diet, went to work and continued their personal habits as before. Blood sugar (Glucoquant) and glucosuria (Clinitest) were regularly controlled before, during and after this period. During long-term ambulatory treatment with the insulin pump improved metabolic control was achieved, as shown by lower mean blood glucose values, decreased urinary glucose excretion and by lowering of hemoglobin AIc. All four patients felt well and the number of complications, all technical, was relatively small.