CoChat
Sign Up
Cited by 49Diabetes Management and ResearchPancreatic function and diabetesDiabetes Treatment and Management

The metabolic and hormonal response to acute normoglycaemia in type 1 (insulin-dependent) diabetes: studies with a glucose controlled insulin infusion system (artificial endocrine pancreas)

Open access
Nosadini, R., Noy, G. A., Nattrass, M., Alberti, K. G. M. M., Johnston, D. G., Home, P. D., �rskov, H.·1982·Diabetologia
DOI 10.1007/bf00252845
Open this paper in CoChat — free accountOpen PDF

Abstract

Twelve insulin deficient Type 1 (insulin-dependent) diabetic subjects were studied over an 11 1/2 h period during both subcutaneous insulin therapy and closed loop insulin delivery, using a glucose controlled insulin system (Biostator) programmed to maintain normoglycaemia. Results were compared with those from 21 age and weight-matched normal subjects. Using the Biostator, normoglycaemia was achieved in all diabetic subjects within 3.5 h and normal profiles maintained thereafter. Blood metabolite and hormone values were evaluated during the subsequent 8 h normoglycaemic period. Subcutaneous therapy resulted in abnormal glucose levels throughout the study period (mean 8 h value 8.3 +/- 0.7 compared with 5.6 +/- 0.3 mmol/l on feedback control and 5.5 +/- 0.1 mmol/l in normal subjects). The mean value of lactate and pyruvate over the final 8 h period was 25% higher in diabetic patients than in normal subjects with no difference between the two insulin treatments (blood lactate: 0.94 +/- 0.04 on subcutaneous insulin, 0.91 +/- 0.04 on feedback control and 0.74 +/- 0.03 mmol/l in control subjects). The pre-prandial peaks of blood glycerol and plasma non-esterified fatty acids were significantly decreased or absent during both feedback control and subcutaneous therapy in comparison with the normal subjects, whereas after the midday and evening meals, total ketone body levels were significantly higher in the diabetic patients. Peripheral serum free insulin levels were two-to fourfold greater in the diabetic than in the normal subjects. There were no significant differences between levels in diabetic patients receiving subcutaneous insulin or on the Biostator. Glucose turnover (1600-1800 h) was normal on feedback control (1.41 +/- 0.20 versus 1.55 +/- 0.18 mg X kg-1 X min-1 in the normal subjects) but was significantly decreased during subcutaneous insulin (1.04 +/- 0.09 mg X kg-1 X min-1). There was, in addition, a decrease in glucose recycling during both subcutaneous insulin therapy and feedback control in the diabetic subjects. These data suggest that although fine control of glucose metabolism both in terms of circulating concentrations and rates of production can be achieved by feedback-control, insulin infusion by the peripheral route is associated with significant metabolic abnormalities, at least in the short term. Longer term studies and examination of portal insulin delivery seem warranted.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/bf00252845

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Some but not all studies that used the Biostator controlled for physical activity levels, meal sizes, composition, and calorie content varied from meal to meal in all but one.

    “Although some (20,24,27) but not all (21–23,26) studies that used the Biostator controlled for physical activity levels, meal sizes, composition, and calorie content varied from meal to meal in all but one (27).”

    From Diurnal Pattern of Insulin Action in Type 1 Diabetes (2013) · cites this paper as [26]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Shipley RA, Clark RE (1972) Tracer methods for in vivo kinetics. Academic Press, New York, pp 111-127

Cited by

Sorted by citations

Related

Authors
Nosadini, R., Noy, G. A., Nattrass, M., Alberti, K. G. M. M., Johnston, D. G., Home, P. D., & �rskov, H.
Affiliations
  • University of Padua (IT)
  • Royal Victoria Infirmary (GB)
  • Birmingham General Hospital (GB)
  • Aarhus Municipality (DK)
ORCID
Johnston, D. G.
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
1982-09
Volume
23
Issue
3
Pages
220-228
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/bf00252845
OpenAlex
W2045908033
Cited by
49
References
43
Citations by year
2013: 1
FWCI
6.72
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
Funders
Medical Research Council
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 1 diabetes, insulin deficiency, artificial pancreas, normoglycemia, subcutaneous insulin therapy, glucose turnover, glucose recycling, lactate, pyruvate, glycerol, free fatty acids, ketone bodies, free insulin, insulin resistance, glucose metabolism, endocrine response
MeSH terms
Adult, Alanine, Blood Glucose, Diabetes Mellitus, Fatty Acids, Nonesterified, Female, Glucagon, Glycerol, Humans, Insulin, Insulin Infusion Systems, Ketone Bodies, Lactates, Male, Middle Aged, Pyruvates, Pyruvic Acid, Lactic Acid

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review