[Feasibility and reproductibility of a euglycemic hyperinsulinic glucose clamp technic]

The euglycemic hyperinsulinaemic clamp is a means for the study of insulin sensitivity. Several techniques have been described: some are manual, others are automatic and use hypertonic glucose (50%). A semi-automatic technique is described using an artificial B cell (Biostator Miles) and a pump (Vial). The method and its reproductibility in ten healthy subjects were studied. The choice of appropriate algorithms ensure a constant and stable insulin level of 93,3 +/- 5 uU/ml and good glycemic feedback through graduated glucose perfusion. The use of a supplementary pump in series with an artificial pancreas insures basic glucose input without recourse to strong concentrations (20%); glycemic feedback of the artificial pancreas is thereby dynamically controlled. The glucose requirement is 8,08 +/- 0,73 mg/kg/min. The same values are found in the same patients three weeks later and resemble those obtained using other techniques. Automatic feedback makes the technique objective; low concentration glucose solution avoids damage to veins.