title: Lispro insulin in people with non-alcoholic liver cirrhosis and type 2 diabetes mellitus.
abstract: OBJECTIVE
  To compare metabolic control under lispro and recombinant regular human insulin (RHI) in people with diet-unresponsive type 2 diabetes mellitus (T2DM) and compensated non-alcoholic liver disease (CLD).
  
  
  METHODS
  108 people with T2DM and CLD were randomly allocated to RHI or lispro according to a 12+12 week cross-over protocol. A 1-week continuous glucose monitoring (CGM) session was performed at the end of each treatment period followed by a standard meal test with a 12IU lispro or RHI shot ahead.
  
  
  RESULTS
  CGM showed higher glycemic excursions under RHI than under lispro (p<0.01) with lower glucose levels in the late post-absorption phase (p<0.05) and even more during the night (p<0.01). Post-challenge incremental areas under the curve (ΔAUC) were undistinguishable for insulin but lower for glucose, while insulin peaked higher and earlier and glycemic excursions were lower with lispro than with RHI (0.05<p<0.001).
  
  
  CONCLUSIONS
  Lispro granted lower early postprandial glucose levels and late postprandial hypoglycemic rates and therefore might represent the treatment of choice for people with T2DM and compensated CLD. This might depend on its faster/shorter-living effects, as well as, on the lower liver glucose output expected from its earlier hepatic distribution.
authors.affiliation: Unit of Internal Medicine, Department of Clinical and Experimental Medicine, 2nd University of Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Gentile
authors.affiliation: Unit of Internal Medicine, Department of Clinical and Experimental Medicine, 2nd University of Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Guarino
authors.affiliation: Diabetes and Endocrinology Unit, St. Peter's Hospital FBF, Rome, Italy. Electronic address: felix.strollo@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Strollo
authors.affiliation: Unit of Gastroenterology, Department of Clinical and Experimental Medicine, 2nd University of Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Romano
authors.affiliation: Diabetes and Metabolic Disease Unit, Cardiovascular Department, IRCCS Multimedica, Sesto San Giovanni (MI), Italy.
authors.forename: S
authors.initials: S
authors.lastname: Genovese
authors.affiliation: Unit of Internal Medicine, Department of Clinical and Experimental Medicine, 2nd University of Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Masarone
authors.affiliation: Instititut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, (AC), Spain.
authors.forename: A
authors.initials: A
authors.lastname: Ceriello
mesh_terms: D001786:Blood Glucose / Q000187:drug effects*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D061268:Insulin Lispro / Q000494:pharmacology / Q000627:therapeutic use*; D061386:Insulin, Regular, Human / Q000494:pharmacology / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; D061386:Insulin, Regular, Human
keywords: Diabetes mellitus; Hypoglycemia; Lispro insulin; Liver cirrhosis