A simple insulin infusion algorithm for establishing and maintaining overnight near-normoglycemia in type I and type...

The purpose of this study was to evaluate the safety and efficacy of an insulin infusion algorithm for establishing and maintaining overnight near-normoglycemia in patients with either type I or type II diabetes. Twenty-nine patients (20 with type I diabetes and 9 with type II diabetes) were infused iv with insulin via an Imed pump from 2100-0730 h; plasma glucose was sampled every 30 min, and adjustments in insulin infusion rates were made every 30 min according to the algorithm. The insulin concentration of the infusate was varied dependent on the patient's weight. Initial (2100 h) plasma glucose concentrations of approximately 15 mmol/L were made near-normoglycemic (plasma glucose, less than 8 mmol/L) in 2-4 h. From 0230-0730 h, plasma glucose averaged approximately 6.3 mmol/L, with a coefficient of variation of 10%. Three patients were given 2-cc injections of 50% glucose for plasma glucose levels less than 4.4 mmol/L. The lowest plasma glucose observed was 3.5 mmol/L. The insulin infusion algorithm described in the present study provides a safe and effective means to establish and maintain near-normoglycemia in adult patients with either type I and type II diabetes.