Abstract
Fourteen insulinopenic diabetics were treated with a closed-loop Biostator Glucose Controller for 24-48 hours followed by 7-10 days of continuous subcutaneous insulin infusion (CSII) in 12 patients. Percent distribution of pre-meal insulin during optimal control with CSII was predicted by the Biostator (r=0.66, slope = 0.89 × intercept=0.24, P<.001). Control during closed-loop feedback, expressed as mean of pre-meal, peak and two hour post meal blood glucose was correlated with HbA1C prior to control (r=0.67, P<.01).
During CSII insulin requirements decreased significantly 19±4.4% M±SE, (P<.025). The decrease in insulin was accompanied by good glucose control: 111±6.9 vs 100±4.3 mg/dl. In the 3 patients displaying the largest decrease in insulin requirements (25-44%) during CSII, initial HbA1C (13.5±1.3%) was greater than in patients whose requirement decreased less (HbA1C 10±.86%, P<.05).
Conclusions 1) Distribution of insulin for programming of CSII can be established with a closed-loop insulin delivery system and may shorten the time required to achieve optimal metabolic control. 2) Metabolic control during closed-loop insulin delivery is influenced by the previous state of control as assessed by HbA1C levels. 3) Over 7-10 days of tight metabolic control with CSII, insulin requirements decreased, with the greatest decrease occurring in patients who have been in poor control.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wohltmann, H., Mayfield, R., Sullivan, F. et al. 1189 USE OF BIOSTATOR GLUCOSE CONTROLLER (CLOSED-LOOP) TO ESTIMATE INSULIN NEEDS ON A PORTABLE PUMP (OPEN-LOOP): EFFECT OF PREVIOUS METABOLIC CONTROL. Pediatr Res 15 (Suppl 4), 641 (1981). https://doi.org/10.1203/00006450-198104001-01215
Issue Date:
DOI: https://doi.org/10.1203/00006450-198104001-01215