title: Insulin Lispro with Continuous Subcutaneous Insulin Infusion is Safe and Effective in Patients with Type 2 Diabetes: A Randomized Crossover Trial of Insulin Lispro Versus Insulin Aspart.
abstract: OBJECTIVE
  This study provides clinical information regarding the use of insulin lispro versus insulin aspart in continuous subcutaneous insulin infusion (CSII) in adult patients with type 2 diabetes mellitus (T2D).
  
  
  METHODS
  After a 2-week lead-in period, 122 subjects treated with CSII therapy were randomized to 32 weeks of treatment during 2 separate 16-week treatment periods (TPs) with crossover beginning with insulin lispro (n = 60) or insulin aspart (n = 62). Glycated hemoglobin A1c (HbA1c), total daily insulin dose, and weight were recorded at the end of TP1 and TP2. Adverse events (AEs) and hypoglycemic events (overall, documented symptomatic, nocturnal, or severe) were recorded throughout the TPs. Data were analyzed using statistical methods that accounted for repeated measurements.
  
  
  RESULTS
  A total of 107 subjects completed the study; 7 discontinued in TP1 and 8 discontinued in TP2. Insulin lispro was noninferior to insulin aspart in endpoint (weeks 16 and 32) HbA1c over TP1 and TP2 combined. Total daily insulin dose, weight change, and incidence and rates of hypoglycemia were not statistically significantly different between treatments. One case of severe hypoglycemia and 1 of diabetic ketoacidosis was observed with insulin aspart. One case of severe infusion site abscess was noted with insulin lispro. Overall, both insulin lispro and insulin aspart were well tolerated with similar AEs reported.
  
  
  CONCLUSIONS
  Insulin lispro and insulin aspart performed similarly after 16 weeks of treatment, with noninferiority for HbA1c and no significant difference in parameters measured. These findings indicate that insulin lispro and insulin aspart can both be used safely and effectively in patients with T2D using CSII.
authors.affiliation: Medical Investigations, Inc., Little Rock, Arkansas.
authors.forename: James
authors.initials: J
authors.lastname: Thrasher
authors.affiliation: Iowa Diabetes and Endocrinology Research Center, Des Moines, Iowa.
authors.forename: Anuj
authors.initials: A
authors.lastname: Bhargava
authors.affiliation: Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana.
authors.forename: Tina M
authors.initials: TM
authors.lastname: Rees
authors.affiliation: Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana.
authors.forename: Tao
authors.initials: T
authors.lastname: Wang
authors.affiliation: Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana.
authors.forename: Cristina B
authors.initials: CB
authors.lastname: Guzman
authors.affiliation: Eli Lilly and Company, Lilly Diabetes, Indianapolis, Indiana.
authors.forename: Leonard C
authors.initials: LC
authors.lastname: Glass
mesh_terms: D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D061267:Insulin Aspart / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D061268:Insulin Lispro / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061267:Insulin Aspart; D061268:Insulin Lispro; C517652:hemoglobin A1c protein, human