title: Lispro is superior to regular insulin in transient intensive insulin therapy in type 2 diabetes.
abstract: OBJECTIVE
  The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context.
  
  
  METHODS
  To explore this possibility, we compared the effect on beta- and alpha-cell function of transient intensive insulin therapy using lispro versus human regular insulin in a total of 21 type 2 diabetic patients who were randomly assigned to 14-days intensive insulin therapy consisting of bedtime NPH insulin plus three injections of mealtime lispro (n=11) or regular insulin (n=10). The dosages of both types of insulin were adjusted to attain preprandial glucose levels of <6.1 mmol/l within 1 week with similar rates of glucose decline. An oral glucose tolerance test (OGTT) was performed at day 0 (baseline), 7, and 14; plasma glucose, serum insulin, and plasma glucagon responses over 0-120 minutes were measured, and calculated as the area under the curve (AUC).
  
  
  RESULTS
  Lispro led to a significant reduction in glucose-AUC and also an increase in insulin-AUC versus regular insulin on day 7. Glucagon secretion following OGTT was well suppressed with lispro on day 14 compared to regular insulin.
  
  
  CONCLUSIONS
  Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid beta-cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits.
authors.affiliation: Department of Internal Medicine, Kanazawa Social Insurance Hospital.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Murase
authors.forename: Kunimasa
authors.initials: K
authors.lastname: Yagi
authors.forename: Masako
authors.initials: M
authors.lastname: Sugihara
authors.forename: Daisuke
authors.initials: D
authors.lastname: Chujo
authors.forename: Michio
authors.initials: M
authors.lastname: Otsuji
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Muramoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mabuchi
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005934:Glucagon / Q000097:blood; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000097:blood; D061268:Insulin Lispro; D007336:Insulin, Isophane / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D005934:Glucagon; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; D007336:Insulin, Isophane