Necrotising glomerulonephritis associated with cholesterol microemboli.

Abstract

mediate acting insulins and were studied twice with an interval of one week in between.Patients were randomised to receive either human Actrapid plus human Monotard or human Velosulin plus human Insulatard initially and then received the other combination during the second period of study.All insulins were of U40 strength.The tests began at least 30 minutes after cannulation.After an overnight fast the morning dose of short acting (mean 12-6 IU, range 4-36 IU) and intermediate acting insulin (mean 32-2 IU, range 16-52 IU) was administered by one of us.The insulins were injected perpendicularly into the thigh immediately after mixing in the syringe (Plastipak).The mean (range) ratio between short and inter- mediate acting insulin was 0-39 (0-11-0 90).After 30 minutes a standard liquid meal (2-1 MJ (500 kcal), 56u( carbohydrate) was taken.Blood glucose concentrations and plasma free insulin concentrations (measured by radio- immunoassay after plasma extraction with macrogol (polyethylene glycol)) were measured at regular intervals for four hours.Statistical analysis was by Student's paired t test and Kendall's rank correlation test.Results are given as means (1 SEM).Postprandial blood glucose concentrations rose to higher peaks after short acting plus lente insulin than after short acting plus isophane insulin: from 9.9 (1-3) to 16-5 (1-5) mmol'l (178 (23 4) to 297 (27) mg/l00 ml) at 130 (9) minutes, compared with from 10-5 (1-2) to 13-6 (1-5) mmol/l (189 (21-6) to 245 (27) mg/1 00 ml) (p < 0-01) at 118 (6) minutes (figure).Blood glucose concentrations were significantly different from 105 to 240 minutes.100 *8