title: Differential effects of adiposity on pharmacodynamics of basal insulins NPH, glargine, and detemir in type 2 diabetes mellitus.
abstract: OBJECTIVE
  To assess the role of adiposity on the pharmacodynamics of basal insulins NPH, detemir, and glargine in type 2 diabetes mellitus (T2DM), as estimated by glucose infusion rate (GIR) and endogenous glucose production (EGP) rate in the euglycemic clamp.
  
  
  METHODS
  We examined the variables that best predicted GIR and EGP in 32-h clamp studies after treatment with subcutaneous injection of 0.4 units/kg NPH, detemir, and glargine in 18 T2DM subjects (crossover).
  
  
  RESULTS
  A multiple regression analysis revealed that BMI best predicted GIR variation during the clamp. BMI was inversely correlated with GIR in all three insulin treatments, but was statistically significant in detemir treatment only. BMI correlated positively with residual suppression of EGP in detemir, but not with glargine and NPH treatments.
  
  
  CONCLUSIONS
  Adiposity blunts the pharmacodynamics of all basal insulins in T2DM. However, as adiposity increases, the effect of detemir is lower versus NPH and glargine.
authors.affiliation: Department of Internal Medicine, Section of Internal Medicine, Endocrinology and Metabolism, University of Perugia, Perugia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Porcellati
authors.forename: Paola
authors.initials: P
authors.lastname: Lucidi
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossetti
authors.forename: Paola
authors.initials: P
authors.lastname: Candeloro
authors.forename: Anna Marinelli
authors.initials: AM
authors.lastname: Andreoli
authors.forename: Stefania
authors.initials: S
authors.lastname: Marzotti
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cioli
authors.forename: Geremia B
authors.initials: GB
authors.lastname: Bolli
authors.forename: Carmine G
authors.initials: CG
authors.lastname: Fanelli
mesh_terms: D050154:Adiposity; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000008:administration & dosage* / Q000627:therapeutic use; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000069057:Insulin Detemir; D007336:Insulin, Isophane