title: Euglycemic infusion of insulin detemir compared with human insulin appears to increase direct current brain potential response and reduces food intake while inducing similar systemic effects.
abstract: OBJECTIVE
  In the treatment of diabetic patients, the long-acting insulin analog insulin detemir is less prone to induce weight gain than other insulin formulations. Assuming that because of its pharmacologic properties, detemir displays stronger central nervous anorexigenic efficacy than human insulin, we compared acute effects of human insulin and detemir on electroencephalography (EEG) measures and food intake.
  
  
  METHODS
  Frontocortical EEG direct current (DC) potentials were recorded in 15 healthy men during two hyperinsulinemic-euglycemic clamps that included an insulin bolus injection (human insulin, 17.75 mU/kg body wt; detemir, 90 mU/kg body wt) followed by a steady 90-min infusion (1.0 vs. 2.0 mU x kg(-1) x min(-1)). A higher dosage was chosen for detemir to compensate for its delay in impact relative to human insulin and to elicit similar systemic effects. At 20 min after infusion, subjects were allowed to eat ad libitum from a test buffet.
  
  
  RESULTS
  Mean glucose infusions to maintain euglycemia (P > 0.93) and blood glucose concentrations (P > 0.34) did not differ between conditions. Detemir infusion induced a negative DC-potential shift, averaging -372.2 microV from 21 to 90 min that was not observed during human insulin infusion (146.5 microV, P = 0.02). Detemir, in comparison with human insulin, reduced subsequent food intake by 303 kcal (1,257 vs. 1,560, P < 0.04).
  
  
  CONCLUSIONS
  While inducing comparable peripheral effects, detemir exerts stronger acute effects on brain functions than human insulin and triggers a relative decrease in food consumption, suggesting an enhanced anorexigenic impact of detemir compared with human insulin on central nervous networks that control nutrient uptake.
authors.affiliation: Department of Neuroendocrinology, University of Lübeck, Lübeck, Germany. hallschmid@kfg.uni-luebeck.de
authors.forename: Manfred
authors.initials: M
authors.lastname: Hallschmid
authors.forename: Kamila
authors.initials: K
authors.lastname: Jauch-Chara
authors.forename: Oliver
authors.initials: O
authors.lastname: Korn
authors.forename: Matthias
authors.initials: M
authors.lastname: Mölle
authors.forename: Björn
authors.initials: B
authors.lastname: Rasch
authors.forename: Jan
authors.initials: J
authors.lastname: Born
authors.forename: Bernd
authors.initials: B
authors.lastname: Schultes
authors.forename: Werner
authors.initials: W
authors.lastname: Kern
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001921:Brain / Q000187:drug effects / Q000502:physiology*; D004569:Electroencephalography; D004576:Electromyography; D004585:Electrooculography; D002149:Energy Intake; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology; D015309:Glucose Clamp Technique; D006801:Humans; D006946:Hyperinsulinism / Q000188:drug therapy / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting; D008297:Male
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir; D005947:Glucose