The role of insulin absorption and sensitivity in determining a diabetic's daily insulin dosage

The change of serum free and total insulin, and of blood intermediary metabolites, growth hormone and cortisol have been determined after separate tests using 0.3 units/kg 'Actrapid MC' given by sc injection and 0.04 units/kg/h by iv infusion in 16 fasted chronic-bovine-insulin-treated diabetics. Eight of these diabetics normally received 32 units or less of conventional, mainly bovine insulin a day and the other eight 128 units or more. Paradoxically the high dose group had a greater fall (5.6 V 3.1 mmol/l; P less than 0.05) in blood glucose four h after the sc insulin injection despite similar pre-insulin values (8.2 and 6.9 mmol/l respectively). Otherwise the responses were markedly similar in the two groups to both sc and iv insulin. Thus the gross differences in daily insulin dosage could not be explained in terms of insulin absorption or sensitivity as assessed by several metabolic parameters.