Better postprandial glucose stability during continuous subcutaneous infusion with insulin aspart compared with insulin lispro in patients with type 1 diabetes.
BACKGROUND
Persistent glucose variability is a frequent condition in type 1 diabetes. Continuous subcutaneous insulin infusion (CSII) is a rational option to overcome this clinical issue; however, no comparative studies have been reported for aspart and lispro insulin when used in CSII. This study compare the effects of aspart and lispro delivered by CSII on glycemic stability as measured using a continuous glucose monitoring system.


METHODS
This single-center, randomized, controlled, 3-day crossover trial included 17 patients with type 1 diabetes. Patients were randomized to receive insulin aspart or insulin lispro. The next day, they received a standard meal at breakfast and lunch and a bolus of insulin aspart or lispro based on insulin:carbohydrate ratio. Patients were monitored for 8 h, after which they received a crossover treatment with insulin aspart or insulin lispro followed by the same procedure as previously.


RESULTS
Postprandial blood glucose was more stable with insulin aspart than insulin lispro (absolute Deltaglucose 7.04 +/- 3.16 vs. 9.04 +/- 4.2, P < 0.0019). Daily blood glucose variability profiles (coefficient of variation and mean amplitude of glucose excursion) and frequency of hypoglycemic episodes (area under the curve <72 mg/dL) were similar with both treatments.


CONCLUSIONS
Postprandial glucose was more stable when insulin aspart was infused as a pre-meal bolus compared with insulin lispro, indicating a more favorable effect of insulin aspart on postprandial glucose. No differences in overall daily glucose stability were observed between insulin aspart and insulin lispro when infused as basal rate insulin.
Bartolo
Paolo Di
PD
Diabetes Unit, Department of Digestive and Metabolic Diseases, Ravenna Health District unit, Ravenna, Italy. p.dibartolo@ausl.ra.it
Pellicano
Francesca
F
Scaramuzza
Antonio
A
Sardu
Cipriana
C
Casetti
Tino
T
Bosi
Emanuele
E
Miselli
Valerio
V
Brandolini
Sara
S
Fabbri
Tiziano
T
Meandri
Piero
P
Cannatà
Francesco
F
D019540:Area Under Curve; D001786:Blood Glucose / Q000378:metabolism*; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D004435:Eating; D006801:Humans; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061267:Insulin Aspart; D007332:Insulin Infusion Systems; D061268:Insulin Lispro; D019518:Postprandial Period; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D061268:Insulin Lispro; D061267:Insulin Aspart