Insulin Pumps: For Whom, When, Why?
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In view of increasing knowledge of the function of the normal human pancreas, it is not surprising that there are now an increasing number of technical innovations that attempt to mimic pancreatic endocrine function. The normal pancreas secretes insulin constantly at a rate based on the metabolic needs of the individual. The basal rate of insulin secretion is relatively constant and comprises about one-half the total 24-hour insulin output, or about 0.3 units/kg/24 hours in the normal individual who is within 80–120% ideal body weight. The normal pancreas also senses blood glucose continuously and gives insulin or initiates counterregulatory activity depending on the absolute value of blood glucose and the rate of change of blood glucose. In addition, through neural input, the pancreas can anticipate ingestion of calories with insulin secretion so that the liver is “primed” to metabolize caloric intake. Finally, insulin is secreted in response to food based not only on the caloric and carbohydrate intake but also on the blood glucose at the moment of eating. Such a system is known as a “closed loop system” since it has the capability to sense glucose and respond appropriately. An open loop system provides only one limb of a closed loop system—either sensing glucose or infusing glucose.
KeywordsClosed Loop System Glucose Sensor Continuous Subcutaneous Insulin Infusion Insulin Pump Normal Pancreas
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