title: Effects of the short-acting insulin analog [Lys(B28),Pro(B29)] on postprandial blood glucose control in IDDM.
abstract: OBJECTIVE
  To establish the effects of the short-acting insulin analog Lispro versus human regular insulin (Hum-R) on postprandial metabolic control in IDDM.
  
  
  METHODS
  Four studies were performed in 10 C-peptide-negative IDDM patients. Lispro or Hum-R (0.15 U/kg) or Lispro + NPH (0.07 U/kg) or Hum-R + NPH were injected subcutaneously 30 min (Hum-R) or 5 min (Lispro) before lunch. Preprandial plasma glucose (PG) was maintained on all four occasions at approximately 7.3 mmol/l by intravenous insulin.
  
  
  RESULTS
  After subcutaneous Lispro injection, plasma free insulin (FIRI) was greater between 0 and 2 h (233 +/- 22 pmol/l) than after Hum-R (197 +/- 25 pmol/l) but lower between 2.25 and 7 h (81 +/- 10 vs. 104 +/- 13 pmol/l, P < 0.05). After Lispro, PG was lower versus Hum-R for 3 h (7.4 +/- 0.6 vs. 8.3 +/- 0.9 mmol/l) but subsequently increased more than after Hum-R (3.25-7h, 11.3 +/- 1 vs. 9.6 +/- 1.2 mmol/l), resulting in a 7-h postprandial PG greater than Hum-R (9.4 +/- 0.5 vs. 8.8 +/- 0.6 mmol/l) (all P < 0.05). Addition of NPH to Lispro increased the 2.5-to 7-h FIRI to 110 +/- 11 pmol/l and decreased the 3.25- to 7-h PG to 7.7 +/- 0.8 pmol/l, resulting in 0- to 7-h PG (7.3 +/- 0.3 mmol/l) lower than after Hum-R + NPH (7.9 +/- 0.5 pmol/l) (P < 0.05).
  
  
  CONCLUSIONS
  At meals, in order for Lispro to improve postprandial blood glucose not only at 2-h, but also over a 7-h period in C-peptide-negative IDDM, basal insulin must be optimally replaced.
authors.affiliation: Department of Internal Medicine, University of Perugia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Torlone
authors.forename: S
authors.initials: S
authors.lastname: Pampanelli
authors.forename: C
authors.initials: C
authors.lastname: Lalli
authors.forename: P
authors.initials: P
authors.lastname: Del Sindaco
authors.forename: A
authors.initials: A
authors.lastname: Di Vincenzo
authors.forename: A M
authors.initials: AM
authors.lastname: Rambotti
authors.forename: F
authors.initials: F
authors.lastname: Modarelli
authors.forename: L
authors.initials: L
authors.lastname: Epifano
authors.forename: G
authors.initials: G
authors.lastname: Kassi
authors.forename: G
authors.initials: G
authors.lastname: Perriello
authors.forename: P
authors.initials: P
authors.lastname: Brunetti
authors.forename: G
authors.initials: G
authors.lastname: Bolli
mesh_terms: D020155:3-Hydroxybutyric Acid; D000328:Adult; D000409:Alanine / Q000097:blood; D000704:Analysis of Variance; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002096:C-Peptide; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005934:Glucagon / Q000097:blood; D005990:Glycerol / Q000097:blood; D006801:Humans; D006885:Hydroxybutyrates / Q000097:blood; D007262:Infusions, Intravenous; D007328:Insulin / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics / Q000494:pharmacology*; D061268:Insulin Lispro; D007336:Insulin, Isophane / Q000494:pharmacology; D007773:Lactates / Q000097:blood; D008297:Male; D019518:Postprandial Period; D011994:Recombinant Proteins / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D005230:Fatty Acids, Nonesterified; D006885:Hydroxybutyrates; D007328:Insulin; D061268:Insulin Lispro; D007773:Lactates; D011994:Recombinant Proteins; D007336:Insulin, Isophane; D005934:Glucagon; D000409:Alanine; D005990:Glycerol; D020155:3-Hydroxybutyric Acid