[The comparison of insulin aspart and human soluble insulin used in insulin pump therapy in newly diagnosed type 2 diabetic patients].
OBJECTIVE
To compare the efficacy of insulin aspart and human soluble insulin used in insulin pump therapy on the islets beta cell function in newly diagnosed type 2 diabetic patients.


METHODS
Fifty-nine hospitalized newly diagnosed type 2 diabetic patients, 35 males and 24 females, aged 51 +/- 12, were and randomly divided into 2 groups to undergo insulin pump therapy with insulin aspart (aspart group, n = 30) or human soluble insulin (human insulin group, n = 29) for 2 weeks. The targets of glycemic control included fasting blood glucose (FBG) < 6.1 mmol/L and 2 h postprandial blood glucose (PBG) < 8.0 mmol/L. The changes of blood glucose, and the time and the doses of insulin needed for good glycemic control were compared between the two groups. The frequency of hypoglycemia and pump-related side effects were recorded.


RESULTS
On the 2nd day of insulin pump therapy, FBG and 3 meals PBG levels were significantly reduced in both groups while the post-breakfast and post-dinner blood glucose levels were far more decreased in the aspart group than in the human insulin group (8.4 mmol/L +/- 2.8 mmol/L vs 11.3 mmol/L +/- 3.8 mmol/L, and 9.0 mmol/L +/- 2.4 mmol/L vs 10.7 mmol/L +/- 2.8 mmol/L, both P < 0.05). The FBG and 3 meals PBG were significantly lowered in the aspart group than in the human insulin group on the 7th day and after the stopping of insulin pump therapy. The time of good glycemic control of the aspart group was 2.0 d, significantly shorter than that of the human insulin group (6.0 d, P < 0.01). The mean dose of insulin used during insulin pump therapy in the aspart group was 0.6 U/kg, significantly less than that in the human insulin group (0.8 U/kg, P = 0.002). There was no significant difference in the AIR, mean area under the curve (AUC) of insulin and C peptide during IVGTT, HOMA-beta and proinsulin between the two groups before and after insulin pump therapy. No pump-related side effects were observed in both groups.


CONCLUSIONS
In newly diagnosed type 2 diabetic patients with short term insulin pump therapy, the use of insulin aspart was more effective and faster with less doses of insulin in acquiring good glucose control compared with humulin R.
Li
Yan-bing
YB
Department of Endocrinology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Liu
Juan
J
Liao
Zhi-hong
ZH
Liao
Ying
Y
Deng
Wan-ping
WP
Weng
Jian-ping
JP
D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D061267:Insulin Aspart / Q000008:administration & dosage / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin; D061267:Insulin Aspart