Long-term improvement in metabolic control of unstable type I diabetes by s.c. insulin injection patterns based on the dose profiles required by bed-side artificial beta-cell.

Abstract

Twenty unselected unstable type I diabetic inpatients whose blood glucose control was insufficient employing three daily s.c. injections of regular insulin supplemented by intermediate acting insulin were subjected to a 48-hour treatment with the Biostator -GCIIS when both diet and muscular exercise were kept as close as possible to the conditions at home. The s.c. injection regimen was adjusted to the insulin dose pattern required by the artificial beta cell. There was significant metabolic improvement in 16 out of the 20 patients on discharge, in comparison to the pre-Biostator conditions. This improvement was still present when the patients were re-admitted after an average of seven months. It is concluded that in certain cases of unstable type I diabetes mellitus the metabolic re-arrangement based on intercalary days on an extracorporal artificial beta cell might be useful if the control constants are adapted to minimize the insulin requirement by the machine.