Abstract
The normalization of metabolism with continuous subcutaneous insulin infusion /CSII/ is still questionable and rapid metabolic decompensation due to mechanical failure is reportedly the most frequent complication. In spite of normal blood glucose /BG/,metabolites and normal resting metabolic rate /RMR/, food-induced thermogenesis /FIT/ measured by indirect calorimetry after a standardized meal was abnormally high /4.7±0.6 kJ/kg lean body weight /LBW//3 hr/ in 12 diabetic children /DC/ as compared to 9 controls /2.9±.0.4 kJ/kg LBW/3 hr/ /p<0.02/. In order to simulate pump-failure and to further study thermogenesis, measurements were repeated on Day 2 except that no insulin was given for 2 to 5 hours. Short-term insulin insufficiency /51±15 vs 272±61 pmol/l, Day 2 vs Day 1, p<0.01/ resulting in hyperglycaemia /BG:16.2±1.6 vs 5.1±0.5 mmol/l, p<0.01/ and mild ketosis /beta-hydroxybutyrate:595±185 vs 50±12 nmol/l, p<0.01/ were associated with rising RMR /5.6±0.3 to 6.4±0.4 kJ/kg LBW/lhr, p<0.005/ and with a markedly reduced PIT /4.7±0.6 vs 3.3±0.4 kJ/kg LBW/3 hr, p<0.01/. In conclusion, in spite of normoglycaemia and normal RMR, PIT was high in DC receiving CSII. During acute insulin-lack RMR rose and PIT was reduced but not abolished.
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Decsi, T., Molnár, D., Soltész, G. et al. 75 ABNORMAL THERMOGENESIS IN DIABETIC CHILDREN RECEIVING CONTINUOUS SUBCUTANEOUS INSULIN INFUSION THERAPY. Pediatr Res 20, 1046 (1986). https://doi.org/10.1203/00006450-198610000-00129
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DOI: https://doi.org/10.1203/00006450-198610000-00129