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Post‐prandial administration of the insulin analogue insulin aspart in patients with Type 1 diabetes mellitus
Author(s) -
Brunner G. A.,
Hirschberger S.,
Sendlhofer G.,
Wutte A.,
Ellmerer M.,
Balent B.,
Schaupp L.,
Krejs G. J.,
Pieber T. R.
Publication year - 2000
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2000.00289.x
Subject(s) - insulin aspart , medicine , insulin , endocrinology , meal , crossover study , postprandial , diabetes mellitus , type 2 diabetes , onset of action , post prandial , placebo , alternative medicine , pathology
Summary Aims In intensified insulin therapy, the recent development of short‐acting insulin analogues with a very rapid onset of action forces a new discussion in terms of the optimal injection–meal interval. This study evaluated prandial glycaemia in patients with Type 1 diabetes following the subcutaneous injection of soluble human insulin (HI) and the insulin analogue insulin aspart (IAsp) at different injection–meal intervals and investigated whether administration of IAsp after the meal might provide satisfactory metabolic control. Methods In a randomized, double‐blind, double‐dummy, four‐period crossover study, 20 Type 1 diabetic patients were investigated. Prandial insulin was administered 15 min before the start of the meal (HI (−15min) ), immediately before the meal (HI (0min) ; IAsp (0min) ) and 15 min after the start of the meal (IAsp (+15min) ). Results Plasma glucose excursions from baseline levels during the 4 h (PG exc ) were highest with HI (0min) (17.9 mmol.l −1 .h; P < 0.05 vs. other treatments) and were not statistically different for HI (−15min) , IAsp (0min) and IAsp (15min) (13.6, 11.9 and 14.2 mmol.l −1 .h, respectively). Maximum concentration of plasma glucose (PG max ) was lowest with IAsp (0min) (11.2 mmol/l; P < 0.05 vs. other treatments). PG max was comparable with HI (−15min) , HI (0min) and IAsp (+15min) (13.3, 14.1 and 13.2 mmol/l, respectively). Conclusions With regard to prandial glycaemia IAsp (+15min) is as effective as HI (− 5min) and superior to HI (0min) . Thus, post‐prandial dosing of the insulin analogue IAsp offers an attractive and feasible therapeutic option for well‐controlled patients with Type 1 diabetes mellitus.