Nighttime Insulin Kinetics and Glycemic Control in Type 1 Diabetes Patients Following Administration of an Intermediate-Acting Lispro Preparation
- Maureen M J Janssen, MD,
- Sandrina Casteleijn,
- Walter Devillé, MD,
- Corrie Popp-Snijders, PHD,
- Paris Roach, MD and
- Robert J Heine, MD, PHD
- Research Institute for Endocrinology, University Hospital Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Vrije Universiteit Amsterdam, The Netherlands
- Lilly Research Laboratories, Eli Lilly and Company Indianapolis, Indiana
- Address correspondence and reprint requests to Robert J. Heine, PhD, Department of Endocrinology, PO. Box 7057, 1007 MB Amsterdam, The Netherlands.
Abstract
OBJECTIVE To determine insulin kinetics and overnight glycemic control after bedtime administration of a new intermediate-acting insulin preparation called neutral protamine lispro (NPL).
RESEARCH DESIGN AND METHODS We studied 12 patients with well-controlled type 1 diabetes. The study had a double-blind, randomized, crossover design. After a lead-in period of 10–14 days two experiments were carried out with an interval of 2–7 days. During these experiments overnight insulin kinetics and fasting blood glucose levels were studied after evening administration of NPH insulin and NPL. Blood glucose levels < 3.8 mmol/l were treated by means of a variable infusion of a 20% glucose solution.
RESULTS A trend toward a shorter time to peak insulin concentration was observed after administration of NPL (P = 0.07). No differences between NPH and NPL were detected in the total area under the curve (AUC) for insulin, in insulin levels before breakfast, or in glucose levels before breakfast (P = 0.5, 0.6, and 0.4, respectively).
CONCLUSIONS We detected no major differences between NPH and NPL in the total AUC for insulin, prebreakfast glucose levels, or prebreakfast insulin levels. Therefore, we conclude that NPH and NPL are equally effective in controlling overnight glycemia.
- Received April 11, 1997.
- Accepted August 11, 1997.
- Copyright © 1997 by the American Diabetes Association
