Hypoglycemia and Counterregulation in Insulin-Dependent Diabetic Patients: A Comparison of Continuous Subcutaneous Insulin Infusion and Conventional Insulin Injection Therapy
- S Ng Tang Fui, MSc, MRCP,
- J C Pickup, BM, DPhil,
- J J Bending, BSc, MRCP,
- Andrea C G Collins, MSc,
- H Keen, MD, FRCP and
- N Dalton, PhD
- Unit for Metabolic Medicine and Department of Chemical Pathology, United Medical and Dental Schools of Guy's and St. Thomas's Hospitals, Guy's Hospital Medical School London SE1 9RT, United Kingdom
- Address reprint requests to Dr. J. C. Pickup, Department of Chemical Pathology, Guy's Hospital Medical School, London SE1 9RT, UK.
Abstract
Eleven insulin-dependent diabetic patients were treated in random order by 2-mo continuous subcutaneous insulin infusion (CSII) or 2-mo conventional injection treatment (CIT)with crossover to the alternative regimen. Mean plasma glucose concentrations throughout the day were significantly lower during CSII than during CIT, but the percentage of plasma glucose values <2.5 mmol/L, obtained from outpatient self-collected diurnal profiles, was similar for both treatments (CSII vs. CIT: 5.9 and 4.8%, respectively). Reported symptomatic hypoglycemia at home was not significantly different in the whole group of patients treated by CSII or CIT but was reduced by a mean of 57% (P < .02) in the five patients on CSII who experienced frequent symptomatic hypoglycemic episodes (>4/2 mo) during CIT. Neither the plasma glucose concentration at which the patients recognizedinduced hypoglycemia nor the glycemic or counterregulatory hormone responses for 60 min thereafter were changed by CSII treatment.
- Copyright © 1986 by the American Diabetes Association
