Biphasic insulin aspart compared to biphasic human insulin reduces postprandial hyperlipidemia in patients with Type 2 diabetes.
BACKGROUND
Premixed insulin analogues reduce postprandial hyperglycemia in patients with Type 2 diabetes in comparison to premixed regular insulin. Insulin also plays an important role in the regulation of postprandial lipid metabolism. It is known that increased levels of postprandial insulin reduce postprandial hyperlipemia but, on the other hand, no information exists with regard to the possible effect of insulin analogues in comparison to human insulin.


METHODS
12 subjects (3 men; age 59 +/- 5 years; BMI 30.5 +/- 5.9 kg/m2, duration of diabetes 9 +/- 1 years, HbA1c 8.33 +/- 1.1 %) already on therapy with premixed insulin were treated either with biphasic human insulin (BHI30) or with biphasic insulin aspart (BIAsp30) (1.3 IU fast acting insulin/12 g KH) in the setting of a standardized test meal. Serum levels of glucose, insulin, C-peptide and triglycerides as well as retinylpalmitate in plasma and chylomicron remnants were determined before and up to 8 hours after the meal.


RESULTS
As was to be expected, therapy with BIAsp30 reduced the maximum increase of postprandial glucose from 7.10 +/- 2.00 mmol/l to 5.27 +/- 1.83 mmo/l (p = 0.007) compared to BHI30 insulin. In the same way, the maximum increase of triglycerides (from 2.33 +/- 1.03 to 1.65 +/- 0.69 mmol/l, p = 0.014) was reduced. The AUC 0 - 8 for triglycerides was not significantly influenced (34.20 +/- 19.86 vs. 31.46 +/- 16.21 mmol x 8 h/l) but the incremental area over baseline (AOB 0 - 8) was significantly reduced from 8.02 +/- 4.35 to 6.12 +/- 3.94 mmol x 8 h/l (p = 0.024).


CONCLUSIONS
Compared to conventional human premixed insulin the prandial therapy with biphasic insulin aspart results not only in an improvement of glucose tolerance but also in a significant reduction of postprandial hyperlipemia.
Schmoelzer
I
I
Diabetic Angiopathy Research Group, Department of Internal Medicine, University of Graz, Graz, Austria.
de Campo
A
A
Pressl
H
H
Stelzl
H
H
Dittrich
P
P
Oettl
K
K
Wascher
T C
TC
D061265:Biphasic Insulins; D053298:Chylomicron Remnants; D002914:Chylomicrons / Q000097:blood; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004224:Diterpenes; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D061267:Insulin Aspart; D007336:Insulin, Isophane; D008297:Male; D019518:Postprandial Period; D000084562:Retinyl Esters; D013997:Time Factors; D014801:Vitamin A / Q000031:analogs & derivatives* / Q000097:blood
D061265:Biphasic Insulins; D053298:Chylomicron Remnants; D002914:Chylomicrons; D004224:Diterpenes; D007004:Hypoglycemic Agents; D007328:Insulin; D000084562:Retinyl Esters; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D014801:Vitamin A; C014794:retinol palmitate; D007336:Insulin, Isophane; D061267:Insulin Aspart