title: Pharmacokinetics and pharmacodynamics of therapeutic doses of basal insulins NPH, glargine, and detemir after 1 week of daily administration at bedtime in type 2 diabetic subjects: a randomized cross-over study.
abstract: OBJECTIVE
  To compare the pharmacokinetics and pharmacodynamics of NPH, glargine, and detemir insulins in type 2 diabetic subjects.
  
  
  METHODS
  This study used a single-blind, three-way, cross-over design. A total of 18 type 2 diabetic subjects underwent a euglycemic clamp for 32 h after a subcutaneous injection of 0.4 units/kg at 2200 h of either NPH, glargine, or detemir after 1 week of bedtime treatment with each insulin.
  
  
  RESULTS
  The glucose infusion rate area under the curve(0-32 h) was greater for glargine than for detemir and NPH (1,538 ± 688; 1,081 ± 785; and 1,170 ± 703 mg/kg, respectively; P < 0.05). Glargine suppressed endogenous glucose production more than detemir (P < 0.05) and similarly to NPH (P = 0.16). Glucagon, C-peptide, free fatty acids, and β-hydroxy-butyrate were more suppressed with glargine than detemir. All 18 subjects completed the glargine study, but two subjects on NPH and three on detemir interrupted the study because of plasma glucose >150 mg/dL.
  
  
  CONCLUSIONS
  Compared with NPH and detemir, glargine provided greater metabolic activity and superior glucose control for up to 32 h.
authors.affiliation: Department of Internal Medicine, Section of Internal Medicine, Endocrinology and Metabolism, University of Perugia, Perugia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Lucidi
authors.forename: Francesca
authors.initials: F
authors.lastname: Porcellati
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossetti
authors.forename: Paola
authors.initials: P
authors.lastname: Candeloro
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cioli
authors.forename: Stefania
authors.initials: S
authors.lastname: Marzotti
authors.forename: Anna Marinelli
authors.initials: AM
authors.lastname: Andreoli
authors.forename: Raffaela
authors.initials: R
authors.lastname: Fede
authors.forename: Geremia B
authors.initials: GB
authors.lastname: Bolli
authors.forename: Carmine G
authors.initials: CG
authors.lastname: Fanelli
mesh_terms: D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002940:Circadian Rhythm; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000008:administration & dosage / Q000493:pharmacokinetics*; D049528:Insulin, Long-Acting
chemical_list: D001786:Blood Glucose; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000069057:Insulin Detemir; D007336:Insulin, Isophane