HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mudaliar, S. Articles by Henry, R. R. Search for Related Content PubMed PubMed Citation Articles by Mudaliar, S. Articles by Henry, R. R. Social Bookmarking                What's this?

Intravenous Glargine and Regular Insulin Have Similar Effects on Endogenous Glucose Output and Peripheral Activation/Deactivation Kinetic Profiles

¹ VA San Diego Healthcare System, La Jolla, California
² Department of Medicine, University of California, San Diego, La Jolla, California
³ Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, California
⁴ Aventis Pharmaceuticals, Bridgwater, New Jersey

OBJECTIVE—To compare the effects of intravenously administered long-acting insulin analog glargine and regular human insulin on activation and deactivation of endogenous glucose output (EGO) and peripheral glucose uptake.

RESEARCH DESIGN AND METHODS—In this single-center, randomized, double-blind, crossover euglycemic glucose clamp study, 15 healthy male volunteers (aged 27 ± 4 years, BMI 24.2 ± 0.7 kg/m² [mean ± SE]) received a primed continuous intravenous infusion of 40 mU/m² of insulin glargine or regular human insulin on 2 different study days in a randomized order. Euglycemia was maintained at 90 mg/dl using a simultaneous variable intravenous infusion of 20% dextrose containing D-[3-³H]glucose. EGO and peripheral glucose disposal kinetics were determined during a 4-h insulin infusion activation period and a 3-h deactivation period.

RESULTS—The results demonstrated no significant difference in activation or deactivation kinetics with respect to EGO and peripheral glucose disposal between insulin glargine and regular human insulin when given intravenously. The mean ± SE time required for 50% suppression of EGO after insulin infusion was 73 ± 23 min for regular insulin and 57 ± 20 min for insulin glargine (NS). The mean maximum rate of glucose disposal was 10.10 ± 0.77 and 9.90 ± 0.85 mg · kg^-1 · min^-1 for regular insulin and insulin glargine, respectively (NS). The mean time required for 50% suppression of incremental glucose disposal rate (GDR), defined as the time required for activation from the basal glucose disappearance rate (R_d) to half-maximum insulin-stimulated R_d, was 32 ± 5 and 42 ± 10 min for regular insulin and insulin glargine, respectively (NS). The time required for deactivation from maximum insulin-stimulated GDR to half-maximum GDR after cessation of insulin infusion was 63 ± 5 and 57 ± 4 min for regular insulin and insulin glargine, respectively (NS).

CONCLUSIONS—Activation and deactivation kinetics of EGO and peripheral glucose uptake as well as absolute disposal rate are similar between regular human insulin and insulin glargine when administered intravenously. Thus, the various biological actions of these insulin preparations when given subcutaneously are completely due to their different absorption kinetics.

Abbreviations: A₅₀EGO, time required for 50% suppression of endogenous glucose output after insulin infusion • A₅₀IGDR, time from basal R_d to half-maximum insulin-stimulated R_d • D₅₀EGO, time required to achieve 50% deactivation from maximum insulin-induced suppression of endogenous glucose output after cessation of insulin infusion • D₅₀IGDR, time required for deactivation from maximum insulin-stimulated glucose disposal rate to half-maximum glucose disposal rate after cessation of insulin infusion • ED₅₀, half maximally effective insulin dose • EGO, endogenous glucose output • FFA, free fatty acid • GDR, glucose disposal rate • hot-GINF, glucose infusion containing D-[3-³H]glucose • IGDR, incremental GDR • R_a, glucose appearance • R_d, glucose disappearance • R_{d max}, maximum rate of glucose disposal

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				J. Westerbacka, R. Bergholm, M. Tiikkainen, and H. Yki-Jarvinen Glargine and Regular Human Insulin Similarly Acutely Enhance Endothelium-Dependent Vasodilatation in Normal Subjects Arterioscler. Thromb. Vasc. Biol., February 1, 2004; 24(2): 320 - 324. [Abstract] [Full Text]