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2 Table 1 Clinical characteristics of pancreatic diabetes patients Fig.1 Correlation between urinary C peptide excretion and nocturnal insulin infusion rate.
3 Table 2 The doses of insulin before and after multiple insulin injection,and the doses of insulin under feedback control with Biostator(R) B:breakfast,L:lunch,D:dinner,MH:Monotard Human,AH:Actrapid Human,IT:Insulatard,VS:Velosulin,HN:Humulin N,HR:Humulin R,NU:Novolin U
4 Table 3 HbAl level,frequency of hypoglycemia,m-value and MAGE before and after multiple insulin therapy
5 Fig.2 Body Mass Index (BMI) before multiple insulin injection and 6 months after multiple inslin injection
6 value, dependent 2) Nosadini R, Prato SD, Tiengo A, Duner E, Toffolo G, Cobelli C, Faronato PP.Moghetti P, Muggeo M (1982) Insulin sensitivity, binding and kinetics in pancreatogenic and type I diabetes. Diabetes 31: ) Schlichtkrull J, Munck O, Jersild M (1985) The M an index of blood suger control in diabetics. Acta Medica Scand. 177: ) Bank S, Marks IN, Vink AI (1975) Clinical and hormonal aspects of pancreatic diabetes. Am. J. Gastroenterol. 64: ) Sjoberg R, Kidd GS (1989) Pancreatic diabetes. Diabetes Care 12: ) Joffe BI, Bank S, Marks IN (1968) Hypoglycemia in pancreatitis. Lancet II: ) Bark S (1966) The management of diabetes in underpriviledged with special reference to pancreatic diabetes. S. Afr. Med. J. 40: ) Barnes AJ, Bloom SR, Crowley MF, Tuttlebee JW (1975) Is glucagon important in stable insulin diabetes? Lancet II:
7 14) Maekawa N,Ohneda A,Kai Y,Saito Y,Koseki S (1978) Secondary diabetic retinopathy in chronic pancreatitis.am J Ophthalmol 85: ) Tiengo A,Segato T,Briani G,Setti A,Prato SD, 11) Joffe BI,Bank S,Jackson WPU (1968) Insulin reserve in patients with chronic pancreatitis.lancet II: Devide A,Podovan D,Virgili F,Crepaldi G (1983) The presence of retinopathy Saudax E,Debry G,Drovin P (1985) The preva- lence of retinopathy is similar in diabetes mellitus 13) Sevel D,Bristow JH,Bank S,Marks I,Jackson P secondary to chronic pancreatitis with or without (1971) Diabetic retinopathy in chronic pancreatitis. Arch Ophthalmol 86: in patients with secondary diabetes following pancreatectomy or chronic pancreatitis.diabetes Care 6: ) Couet C,Genton P,Pointel JP,Lois J,Gross P, pancreatectomy and in idiopathic diabetes mellitus. Diabetes Care 8: Abstract Clinical Efficacy of Multiple Insulin Injection Regimen in Pancreatogenic Diabetes Junk o Miura,Junichi Yokoyama,Akira Mimura,Yutaka Mori,Kageki Ito and Yoshio Ikeda The 3rd Department of Internal Medicine,Jikei University School of Medicine Patients with pancreatogenic diabetes (PD),secondary either to chronic calcified pancreatitis or to pancreatectomy,become unpredictably hypoglycemic during conventional insulin therapy and often have so-called brittle diabetes.we investigated insulin requirements in feedback control performed with Biostator(R) in 11 PD.On the basis of these data,a multiple insulin injection regimen was designed and evaluated in comparison with previous conventional insulin regimens in 16 PD.PD requiring nocturnal insulin infusion of more than 1.0 U/hr in feedback control were treated with prandial actrapid insulin (Bolus),using a pen injector,and once with ultratard insulin injection (Basal),PD requiring nocturnal insulin infusion of less than 1.0 U/hr were treated only with Bolus. HbAi significantly decreased after the Bolus or Basal-Bolus regimen ( % vs %,p< 0.01).The M-value also decreased significantly after the Bolus or Basal-Bolus regimen ( vs ,p <0.01).Furthermore,mean amplitude of glycemic exclusion and frequency of hypoglycemic events were remarkably improved.these results suggest that a multiple insulin injection regimen should be considered in PD despite the fact that PD can be controlled by single injection with relatively small doses of insulin. J.Japan Diab.Soc.34 (8): ,1991
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