The improved response in endogenous insulin due to continuous subcutaneous infusion of insulin therapy in juvenile diabetes.

Abstract

We investigated the relationship between the recovery or improved response of endogenous insulin and the control of blood glucose in juvenile diabetes (IDDM) treated with the continuous subcutaneous infusion of insulin (CSII). (1) It is unlikely that the decrease in endogenous insulin secretion over several years following onset of IDDM in 43 subjects was uniform in terms of urinary c-peptide (u-CPR) excretion. (2) In 27 newly diagnosed cases of IDDM, the group receiving CSII (n = 18) showed more satisfactory results, including greater stability of blood glucose, a more rapid decrease in insulin requirements and an earlier improvement in u-CPR compared to the control group who were receiving conventional subcutaneous insulin therapy (n = 9). (3) U-CPR increased with the improvement in blood glucose control within 2 to 4 wks of the initiation of CSII in 6 of 8 already-treated cases of IDDM, while daily insulin requirements did not differ significantly before and after CSII. Since short-term CSII therapy improved u-CPR response by normalizing blood glucose not only in newly diagnosed but also known diabetic, therapy should be directed toward the long-term intensive control of blood glucose in order to maintain the potency of endogenous insulin secretion especially in newly-diagnosed cases of insulin secretion especially in newly-diagnosed cases of IDDM.