Continuous subcutaneous insulin infusion: improved blood-glucose and intermediary-metabolite control in diabetics

Blood-levels of glucose and the major intermediary metabolites, lactate, pyruvate, 3-hydroxybutyrate, and alanine, were measured in 7 insulin-dependent diabetics during 24 h of continuous subcutaneous insulin infusion (C.S.I.I.) from a portable dual-rate syringe pump. Results were compared with metabolic profiles during the patients' conventional insulin treatment and with those of 17 non-diabetics. The mean 24 h plasma-glucose during C.S.I.I. was not significantly different from that in non-diabetics. During infusion blood concentrations of lactate, pyruvate, 3-hydroxybutyrate, and alanine were also close to those in the non-diabetic state. Thus, C.S.I.I. provides strict control not only of blood-glucose but also of major metabolites, an essential prerequisite for investigating the influence of good metabolic control on diabetic microangiography.