Clinical usefulness of artificial endocrine pancreas "Biostator" in management of unstable diabetics.

Abstract

The diurnal blood glucose profiles of 15 unstable diabetics were continuously monitored by the artificial endocrine pancreas (AEP, Biostator). Then, feedback control (FC) with the AEP was performed on each subject for 24-32 hr. Based on the data obtained from FC, the patients received an intensified conventional insulin therapy (ICIT) consisting of two daily mixed injections, 45-60 min prior to meals. There was a negative correlation between the MAGE and the sum of serum CPR in a 50 g OGTT, before FC. The M-value, MBG and MAGE decreased significantly during FC and remained lower one month later, compared with those values obtained before FC. The ICIT caused a noticeable decrease in HbA1 levels one to four months after FC. The ICIT was characterized by an increase in the proportion of short-acting insulin in the daily insulin dosage to 40. 3 +/- 11.5%. The proportion of daily insulin dosage to body weight also increased to 0.73 +/- 0.17 U/kg. These results suggest that the AEP, Biostator, could be useful in the clinical management of unstable diabetics by providing a more precise estimate of patients insulin requirements, especially those of short-acting insulin, leading to a better long-term control of blood glucose.