The rapid-acting properties of insulin aspart are preserved in elderly people with type 2 diabetes.
OBJECTIVE
Elderly type 2 diabetes patients may face increased risk of hypoglycaemic episodes because of unpredictable eating habits. The pharmacokinetics and pharmacodynamics of insulin aspart (IAsp) were studied in elderly patients to examine the potential for postprandial dosing.


METHODS
Nineteen type 2 diabetes subjects, aged > or =65 years, were enrolled in this randomized, double-blind, crossover trial. Subjects received 0.3 U/kg IAsp or regular human insulin during a glucose clamp procedure.


RESULTS
IAsp showed a faster onset of action with significantly higher values for area under the glucose infusion rate curves, AUC(GIR(0-120 min)) and AUC(GIR(0-300 min)) (p = 0.0001). Maximum metabolic activity was higher (4.4 vs. 3.8 mg/kg/min, p = 0.0039) and occurred earlier with IAsp (196 vs. 278 min, p < 0.0001). Late metabolic activity (AUC(GIR (300-600 min))) was significantly lower with IAsp (p = 0.0006).


CONCLUSIONS
Clinical studies are required to confirm whether postprandial administration of IAsp is appropriate for elderly patients.
Krones
R
R
St Franziskus Hospital, Clinic for Internal Medicine, Cologne, Germany.
Schütte
C
C
Heise
T
T
D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007004:Hypoglycemic Agents / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives* / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D061267:Insulin Aspart; D008297:Male
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D061267:Insulin Aspart