Effects of basal rate verification on CSII dose adjustments in brittle diabetes

Abstract

Basal rate verification is the process to find and verify the basal rate of continuous subcutaneous insulin infusion (CSⅡ) required for basal glucose metabolism.In the present study,five cases of brittle diabetes were treated by CSⅡ with Insulin Lispro.After doses were adjusted to reach steady blood glucose levels,basal rate verifying tests were carried out.The results showed that the overall level and stability of blood glucose were improved markedly after CSⅡ.Before and after the verification of the basal rate,there was no significant difference in CSⅡ total doses.Basal rates decreased from 50％ of total to 30％ (P＜0.05),and boluses increased to 70％ (P＜0.05).The basal rates during lunch and supper time were reduced by half (P＜0.05),the boluses of lunch and supper were increased 1.5 times (P＜0.05),and square waves were needed to control postprandial blood glucose.These results suggest that the CSⅡ could smoothly control blood glucose level in brittle diabetes without basal rate verification.However,the implementation of the verification could better determine the basal rates for basal glucose metabolism,and thus help to identify diet-related boluses. Key words: Brittle diabetes; Continuous subcutaneous insulin infusion; Basal rate verification