P rogressive hyperglycemia in type 2 diabetes results from a progressive b-cell failure together with a state of insulin resistance (1). Insulin deficiency worsens with the natural progression of type 2 diabetes, explaining the escape from oral antihyperglycemic agents and the need for exogenous insulin therapy (2). The use of external pumps in patients with type 2 diabetes is a recent practice...

Nicotinic acid (NA) has been used as a lipid drug for five decades. The lipid-lowering effects of NA are attributed to its ability to suppress lipolysis in adipocytes and lower plasma FFA levels. However, plasma FFA levels often rebound during NA treatment, offsetting some of the lipid-lowering effects of NA and/or causing insulin resistance, but the underlying mechanisms are unclear. The prese...

34.Kelley DE, Henry RR, Edelman SV: Acute effects of intraperitoneal versus subcutaneous insulin delivery on glucosehomeostasis in patients with NIDDM. Veterans Affairs Implantable Insulin Pump Study Group. Diabetes Care 19:1237-1242,1996 Abstract 35.Jennings AM, Lewis KS, Murdoch S, et al: Randomized trial comparing continuous subcutaneous insulin infusion and conventional insu...

Increasingly more Americans are being diagnosed with diabetes mellitus, and the number of those using the continuous subcutaneous insulin infusion pump (CSII), commonly known as the insulin pump, is on the rise. Although evidence is lacking on how best to manage insulin pump patients perioperatively, several individual or institutional approaches have been developed. Here we propose a comprehen...

Under basal and stimulated conditions, normal insulin secretion oscillates with periods in the ultradian 100-150-min range. To test the hypothesis that oscillatory insulin delivery is more efficient in reducing blood glucose levels than continuous administration, nine normal young men were each studied on two occasions during a 28-h period including a period of polygraphically recorded sleep. E...

Poor penetration of vancomycin into Central Nervous System (CNS) can lead to treatmentfailure. The aim of this study was to evaluate and compare CSF concentration and serumpharmacokinetics of high dose vancomycin by continuous infusion vs. intermittent infusion inpost neurosurgical meningitis patients. Twenty patients were divided into two groups. Patientsin intermittent infusion group received...

Poor penetration of vancomycin into Central Nervous System (CNS) can lead to treatmentfailure. The aim of this study was to evaluate and compare CSF concentration and serumpharmacokinetics of high dose vancomycin by continuous infusion vs. intermittent infusion inpost neurosurgical meningitis patients. Twenty patients were divided into two groups. Patientsin intermittent infusion group received...

Ruminants remain productive during the energy insufficiency of late pregnancy or early lactation by evoking metabolic adaptations sparing available energy and nutrients (e.g. higher metabolic efficiency and induction of insulin resistance). A deficit in central leptin signaling triggers these adaptations in rodents but whether it does in ruminants remains unclear. To address this issue, five ma...

Sixty-eight determination of in vivo insulin resistance were conducted in 35 males (aged 29-63 yr) by measurement of steady-state plasma glucose levels during a combined intravenous infusion of propranolol, epinephrine, glucose, and insulin. Subjects were mildly diabetic and/or hyperlipidemic. All were asymptomatic, denied taking medication, and had no history of cardiac disease. All had normal...