title: Better postprandial glucose stability during continuous subcutaneous infusion with insulin aspart compared with insulin lispro in patients with type 1 diabetes.
abstract: 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.
authors.affiliation: Diabetes Unit, Department of Digestive and Metabolic Diseases, Ravenna Health District unit, Ravenna, Italy. p.dibartolo@ausl.ra.it
authors.forename: Paolo Di
authors.initials: PD
authors.lastname: Bartolo
authors.forename: Francesca
authors.initials: F
authors.lastname: Pellicano
authors.forename: Antonio
authors.initials: A
authors.lastname: Scaramuzza
authors.forename: Cipriana
authors.initials: C
authors.lastname: Sardu
authors.forename: Tino
authors.initials: T
authors.lastname: Casetti
authors.forename: Emanuele
authors.initials: E
authors.lastname: Bosi
authors.forename: Valerio
authors.initials: V
authors.lastname: Miselli
authors.forename: Sara
authors.initials: S
authors.lastname: Brandolini
authors.forename: Tiziano
authors.initials: T
authors.lastname: Fabbri
authors.forename: Piero
authors.initials: P
authors.lastname: Meandri
authors.forename: Francesco
authors.initials: F
authors.lastname: Cannatà
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D007328:Insulin; D061268:Insulin Lispro; D061267:Insulin Aspart