Comparison of the post-meal glucose response to different insulin bolus waveforms in insulin pump- and pre-meal pramlintide-treated type 1 diabetes patients

Diabetes Technology & Therapeutics
Allen B King

Abstract

Both pramlintide and insulin pump waveforms separately provide improved post-meal glucose control. However, when used together there may be a mismatch in actions leading to hypoglycemia. We studied the three currently available waveforms and a "modified combination wave" (MC) in pramlintide-treated patients. The MC was a "square" (SQ) wave combined with a "standard" (ST) bolus that was delayed 1 h into the mealtime. Using the CGMS Gold (Medtronics, Northridge, CA) we measured the glucose response 0-4 h after the beginning of a meal and 15 min after the initiation of the insulin bolus wave and pramlintide (60 microg), bolus. Pump-treated type 1 diabetes subjects were randomized to one bolus waveform for one full day of three meals and then crossed over to the other bolus waveforms. In the first study nine subjects were randomized to the ST, SQ, or "combination" (C) wave consisting of a ST wave at the beginning of a SQ wave. In the second study nine subjects were randomized to SQ or MC. With ST and C waves glucose fell approximately 40 mg/dL 0-2 h post-meal and then returned to baseline by the fourth hour. Initially isoglycemic, the SQ wave increased approximately 20 mg/dL in the late meal period. The MC demonstrated minimal (app...Continue Reading

References

Oct 8, 1999·Diabetic Medicine : a Journal of the British Diabetic Association
Apr 10, 2002·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Gabriela BrentaGustavo Saubidet
Apr 12, 2002·Diabetic Medicine : a Journal of the British Diabetic Association·H P ChaseS K Garg
Apr 30, 2002·Metabolism: Clinical and Experimental·M S FinemanO G Kolterman
Jan 6, 2009·Diabetes Care·UNKNOWN American Diabetes Association

❮ Previous
Next ❯

Citations

May 14, 2011·Expert Opinion on Pharmacotherapy·Lisa M YounkStephen N Davis
Jun 20, 2018·Diabetes Technology & Therapeutics·Halis Kaan AkturkSatish K Garg
Jun 14, 2015·Pharmacological Reviews·Debbie L HayJonathan D Roth
Nov 1, 2012·Expert Review of Endocrinology & Metabolism·Harold E Lebovitz

❮ Previous
Next ❯

Related Concepts

Related Feeds

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.