Characteristics of Glycemic Stability

Glucose homeostasis in healthy subjects is characterized by postmeal glucose increases of about 40 mg/dl, peaks at about 45 min, decreases close to antecibal levels 1 h after the peak, and no spontaneous oscillations until the next meal. Diabetes is characterized by progressive loss of glucose homeostasis from stable to unstable, which is directly proportional to loss of insulin secretory reserve. Degree of instability of diabetes in ambulatory subjects within a 24-h period can be expressed as mean amplitude of glycemic excursion of M-value and between two successive 24-h periods as mean of daily differences of blood glucose. Stable diabetic persons have lower values, which are closest to those of nondiabetic persons, and unstable diabetic persons have higher values. The mean diurnal blood glucose level is a measure of glycemic control. The failure to restore glycemic patterns of diabetic to those of nondiabetic persons is largely due to the failure of subcutaneously administered insulin to mimic the pattern of insulinemia of healthy subjects.

[1]  M. Jersild.  Insulin zinc suspension; four years' experience. , 1956, Lancet.

[2]  J. Schlichtkrull,et al.  THE M-VALVE, AN INDEX OF BLOOD-SUGAR CONTROL IN DIABETICS. , 1965, Acta medica Scandinavica.

[3]  F. Service.  Normalization of plasma glucose of unstable diabetes: studies under ambulatory, fed conditions with pumped intravenous insulin. , 1978, The Journal of laboratory and clinical medicine.

[4]  R. D. Lawrence,et al.  Treatment of diabetes mellitus with insulin zinc suspension; a clinical study based on 479 cases. , 1955, British medical journal.

[5]  Å. Nordén,et al.  Analysis of variance applied to blood glucose values for assessing insulin preparations and state of lability in diabetes , 1969, Diabetologia.

[6]  W. F. Taylor,et al.  Growth hormone and glucose interrelationships in diabetes: studies of inadvertent hypoglycemic episodes during continuous blood glucose analysis. , 1971, The Journal of clinical endocrinology and metabolism.

[7]  J. Schlichtkrull,et al.  The lente insulins, insulin-zinc suspensions. , 1954, Danish medical bulletin.

[8]  A. Cherrington,et al.  Evidence for an important role of glucagon in the regulation of hepatic glucose production in normal man. , 1977, The Journal of clinical investigation.

[9]  W Zingg,et al.  Clinical Control of Diabetes by the Artificial Pancreas , 1974, Diabetes.

[10]  W. F. Taylor,et al.  Mean Amplitude of Glycemic Excursions, a Measure of Diabetic Instability , 1970, Diabetes.

[11]  W. F. Taylor,et al.  Studies of diabetic instability. II. Tests of insulinogenic reserve with infusions of arginine, glucagon, epinephrine, and saline. , 1971, Metabolism: clinical and experimental.

[12]  M. Mackenzie,et al.  Lack of Influence of Insulin-induced Hypoglycemia on Alimentary Hyperglycemia , 1966, Diabetes.

[13]  W. F. Taylor,et al.  Growth hormone and glucose interrelationships in diabetes: studies with insulin infusion during continuous blood glucose analysis. , 1969, The Journal of clinical endocrinology and metabolism.

[14]  S. Tarui,et al.  Studies on the Etiology of “Brittle Diabetes”: Relationship Between Diabetic Instability and Insulinogenic Reserve , 1977, Diabetes.

[15]  K. Moxness,et al.  Quantitative Aspects of Labile Diabetes , 1965, Diabetes.

[16]  J. Izzo,et al.  A clinical comparison of modified insulins. , 1950, The Journal of clinical investigation.

[17]  J. I. Goodman.  Causes of labile diabetes: its treatment. , 1955, The American journal of medicine.

[18]  R. Tattersall.  Brittle diabetes. , 1977, Clinics in Endocrinology and Metabolism.

[19]  A H Clemens,et al.  The artificial beta cell--a continuous control of blood sugar by external regulation of insulin infusion (glucose controlled insulin infusion system). , 1974, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.