title: A 12-wk follow-up study to evaluate the effects of mixing insulin lispro and insulin glargine in young individuals with type 1 diabetes.
abstract: OBJECTIVE
  This study was performed to compare in real-life conditions the serum profile of insulin lispro (IL) after a subcutaneous (SC) injection, separate and mixed with insulin glargine (IG), using a sensitive radioimmunoassay for the specific determination of serum IL, and to evaluate the 12-wk effect of the mixture on glycemic control in young individuals with type 1 diabetes.
  
  
  METHODS
  The IL serum profiles were evaluated in 10 individuals with type 1 diabetes [age 21.9 ± 3.8 yr; diabetes duration 13.4 ± 4.9 yr; body mass index 25.1 ± 3.2 kg/m2; hemoglobin A1c (HbA1c) 8.3 ± 0.8%] during a mixed meal test (MMT) using IL and IG as separate (baseline) and mixed injection. The glycemic variability by continuous glucose monitoring system (CGMS) and the long-term diabetes control with HbA1c were also evaluated at baseline and after 12 wk mixing the two insulins.
  
  
  RESULTS
  The mixture of IL with IG decreased IL maximum serum concentration (Cmax(IL) ) (29.4 ± 5.1 µU/mL vs. 13.7 ± 4.2 µU/mL; p = 0.03) without changing the time to reach the Cmax (Tmax(IL) ), the IL area under the curve (AUC(IL) (0-240) ), and the glucose dynamics during the MMT. The glucose variability and the HbA1c were equivalent to baseline after 12 wk mixing both insulins.
  
  
  CONCLUSIONS
  These data suggest that mixing IL with IG immediately before the SC injection decreases IL serum peak concentration without affecting the glycemic profile after 12 wk in this group with type 1 diabetes mellitus.
authors.affiliation: The Endocrinology Division, Diabetes Center, Department of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil. maria.beatriz@unifesp.br
authors.forename: Maria B B
authors.initials: MB
authors.lastname: Lucchesi
authors.forename: William R
authors.initials: WR
authors.lastname: Komatsu
authors.forename: Monica A L
authors.initials: MA
authors.lastname: Gabbay
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Dib
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D007328:Insulin / Q000097:blood / Q000627:therapeutic use; D000069036:Insulin Glargine; D061268:Insulin Lispro / Q000008:administration & dosage* / Q000097:blood; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D008297:Male
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000069036:Insulin Glargine; D061268:Insulin Lispro; D049528:Insulin, Long-Acting; C517652:hemoglobin A1c protein, human