The effect of hyperglucagonaemia on blood glucose concentrations and on insulin requirements during fasting in insulin dependent diabetes mellitus.

The effect of sustained hyperglucagonaemia on blood glucose concentrations and on insulin requirements was evaluated in 6 fasting insulin dependent diabetic subjects whose blood glucose concentrations were being controlled with a closed loop insulin infusion system. Subjects were iv infused initially with either saline or glucagon and subsequently with the other infusate. All determinations were performed following the period during which transient increases in glucagon stimulated glucose production have been reported to occur. Plasma glucagon concentrations were significantly higher during the glucagon study period (491 +/- 65 vs 70 +/- 13 pg/ml +/- SD, P less than 0.001) as were blood glucose concentrations (104 +/- 2 vs 84 +/- 7 mg/ml +/- SD, P less than 0.001) and insulin requirements (3.5 to 36.5 vs 0 to 2.3 mU/kg/h, P less than 0.05). Sustained hyperglucagonaemia continues to have an effect on glucose homeostasis for at least 2 h following the initiation of a continuous infusion.

Evaluation of a new reflectance photometer for use in home blood glucose monitoring.

A new reflectance photometer (Glucometer, Ames Division, Miles Laboratories, Elkhart, Indiana) has been developed for use with the Dextrostix reagent strip. The device measures 8 X 17 cm, weighs 330 g, uses AA batteries, and requires no warm-up. High (330 mg/dl) and low (50 mg/dl) calibrations are stored in memory and need be repeated only when: (1) a control solution (100 mg/dl) reading is in error, (2) ambient temperature changes by more than 5 degrees C, (3) a new bottle of Dextrostix is used, and (4) batteries are changed. A 60-s timer with alarm helps make timing of the procedure consistent. Nineteen insulin-dependent and one non-insulin-dependent diabetic subjects each performed a minimum of 20 blood glucose determinations over a 3-mo period in the investigators' laboratories. Simultaneous capillary blood samples were obtained for plasma glucose analysis by a comparative method. A total of 602 patient-determined glucose values ranging from 30 to 400 mg/dl were compared with simultaneous laboratory values. These values correlated significantly (r = 0.96, P less than 0.0001, y = 2.6 + 0.92x). The Glucometer-Dextrostix System is an accurate and convenient method for home blood glucose monitoring by diabetic patients.