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Insulin administered by needle‐free jet injection corrects marked hyperglycaemia faster in overweight or obese patients with diabetes
Author(s) -
de Wit H. M.,
Engwerda E. E. C.,
Tack C. J.,
de Galan B. E.
Publication year - 2015
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12550
Subject(s) - medicine , insulin , overweight , diabetes mellitus , endocrinology , insulin aspart , crossover study , pharmacodynamics , type 2 diabetes , pharmacokinetics , confidence interval , body mass index , placebo , alternative medicine , pathology
Aims To test whether jet injection of insulin resulted in faster correction of marked hyperglycaemia than when insulin is injected by a conventional pen in patients with diabetes. Methods Adult, overweight or obese ( BMI ≥25 and ≤40 kg/m 2 ) patients with type 1 diabetes (n = 10) or insulin‐treated type 2 diabetes (n = 10) were enrolled in a randomized, controlled, crossover study. On two separate occasions, patients were instructed to reduce insulin dose(s) to achieve marked hyperglycaemia (18–23 mmol/l). Subsequently, insulin aspart was administered either by jet injection or by conventional pen, in a dose based on estimated individual insulin sensitivity. Pharmacodynamic and pharmacokinetic profiles were derived from plasma glucose and insulin levels, measured for 6 h after injection. Results After conventional injection, plasma glucose concentration dropped by ≥10 mmol/l after 192.5 ± 13.6 min. The jet injector advanced this time to 147.9 ± 14.4 min [difference 44.6 (95% confidence interval 4.3, 84.8); P = 0.03], except in 3 patients who failed to reach this endpoint. The time advantage exceeded 1.5 h in patients with a BMI above the median. Jet injection also reduced the hyperglycaemic burden during the first 2 h (2042 ± 37.2 vs 2168 ± 26.1 mmol/min; P = 0.01) and the time to peak insulin levels (40.5 ± 3.2 vs 76.8 ± 7.7 min; P < 0.001), but did not increase the risk for hypoglycaemia. Conclusions Administration of rapid‐acting insulin by jet injection results in faster correction of marked hyperglycaemia in overweight or obese patients with insulin‐requiring diabetes.