[en] Seven obese Type 2 diabetic patients were studied for two 4-h periods after ingestion of a glucose load to determine the effects of preprandial subcutaneous injection of Insulin Lispro (5 min before the meal) or regular insulin (20 min before the meal) on glucose metabolism. Glucose production and utilisation were measured using a dual isotope method. After Lispro, the mean postprandial increase in plasma glucose was 29% lower and the increase in insulin concentration 25% higher than after regular insulin (p < 0.05). Suppression of endogenous glucose production was similar with both types of insulin. Thus, preprandial injection of Lispro reduced postprandial glucose increments in Type 2 diabetic patients as compared to regular insulin. This effect is best explained by the increased postprandial bioavailability of Lispro.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Paquot, Nicolas ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Roulin, D.
Schneiter, P.
Ruiz, J.
Lefèbvre, Pierre ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Pahud, P.
Tappy, L.
Language :
English
Title :
Effects of Regular Insulin or Insulin Lispro on Glucose Metabolism after an Oral Glucose Load in Patients with Type 2 Diabetes Mellitus
DeFronzo RA. The triumvirate : β-cell, muscle, liver. A collusion responsible for NIDDM. Diabetes, 1988, 37, 667-687.
Brunzell JD, Robertson P, Lerner RL, et al. Relationship between fasting plasma glucose levels and insulin secretion during intravenous glucose tolerance tests. J Clin Endocrinol Metab, 1976, 42, 222.
Mitrakou A, Kelley D, Mokan M, et al. Role of reduced suppression of glucose production and diminished early insulin release in impaired glucose tolerance. N Engl J Med. 1992, 326, 22-29.
Rosenzweig JL. Principles of insulin therapy. In : Kahn CR, Weir GC, eds. Joslin's Diabetes Mellitus, 13th ed. Philadelphia : Lea & Febiger, 1994, 460-488.
Torlone E, Pampanelli S, Lalli C, et al. Effects of the short-acting insulin analog (lys (B28), Pro (B29) on postprandial blood glucose control in IDDM. Diabetes Care. 1996, 19, 945-952.
Anderson JH, Jr., Brunelle RL, Koivisto VA, et al. Reduction of postprandial hyperglycemia and frequency of hypoglycemia in IDDM patients on insulin-analog treatment. Diabetes, 1997, 46, 265-270.
Anderson JHJ, Brunelle RL, Keohane P, et al. Mealtime treatment with insulin analog improves postprandial hyperglycemia and hypoglycemia in patients with non-insulin-dependent diabetes mellitus. Multicenter Insulin Lispro Study Group. Arch Int Med, 1997, 15, 1249-1255.
Anderson JH, Jr., Brunelle RL, Koivisto VA, Trautmann ME, Vignati L, DiMarchi R. Improved mealtime treatment of diabetes mellitus using an insulin analogue. Multicenter Insulin Lispro Study Group. Clin Ther, 1997, 19, 62-72.
Bruttomesso D, Pianta A, Valerio A, Tadiotto F, Lavagnini T, Del Prato S. Fast-acting insulin analog (LISPRO) improves glucose tolerance of NIDDM by inhibiting hepatic glucose production. Diabetes. 1996, 45, Suppl. 2. 140A.
Durnin JVGA, Womersley J. Body fat assessment for total body density and its estimation from skinfold thickness : measurements on 481 men and women aged from 16 to 72 years. Br J Nutr, 1974, 3, 77-97.
Jallut D, Tappy L, Kohut M, et al. Energy balance in elderly patients after surgery for a femoral neck fracture. J Parenter Enter Nutr, 1990, 14, 563-568.
