The basal rate characteristics of continuous subcutaneous insulin infusion in adult type 1 diabetes with islet failure / 中华内分泌代谢杂志

ABSTRACT

Objective To investigate the basal rate characteristics of continuous subcutaneous insulin infusion(CSII)in adult type 1 diabetes with islet failure. Methods Adult type 1 diabetic patients with islet failure, treated by CSII for more than 12 months but with poor glycemic control,were optimized for insulin dose through basal rate verification. The differences of blood glucose levels and insulin dosages were compared before and after CSII dose optimization. Results In 16 cases,HbA1Creduced from(7.6 ± 1.1)% by the time of enrollment to(7.0 ± 0.5)% after dose optimization(P<0.05),the minimal blood glucose level rose from(3.1 ± 1.1)mmol/L to(4.5 ± 0.7) mmol/L(P<0.01),and the maximal blood glucose level dropped from(18.6 ± 2.3)mmol/L to(12.0 ± 1.5)mmol/L (P<0.01). The total daily dosage of CSII reduced by about 17% (P<0.01)and the total basal insulin dosage reduced by about 43%(P<0.01)after dose optimization. The percentage of total basal insulin dosage to total daily dosage reduced from(43.6 ± 9.9)% by the time of enrollment to(29.4 ± 3.5)% after dose optimization(P<0.01). During 24 hours of the day,basal rate at 03 00-08 00 reached the peak level(1.3 times of the hourly average basal rate level)and basal rate at 20 00-24 00 fell to the valley level(60% of the hourly average basal rate level). Conclusions In adult type 1 diabetic patient with islet failure,the total basal insulin requirement of CSII is about 30% of the total daily dosage,with the peak level at 03 00-08 00 and the valley level at 20 00-24 00.