Comparison of Insulin Aspart and Lispro
Pharmacokinetic and metabolic effects
- Carol Homko, RN, PHD,
- Antonio Deluzio, DO,
- Carolyn Jimenez, PHD,
- Jerzy W. Kolaczynski, MD, PHD and
- Guenther Boden, MD
- From the General Clinical Research Center and Division of Endocrinology/Diabetes/Metabolism, Temple University School of Medicine, Philadelphia, Pennsylvania
- Address correspondence and reprint requests to Guenther Boden, Temple University Hospital, 3401 N. Broad St., Philadelphia, PA 19140. E-mail: bodengh{at}tuhs.temple.edu.
Abstract
OBJECTIVE—To compare insulin levels and actions in patients with type 1 diabetes after subcutaneous injection of the rapid-acting insulin analogs aspart and lispro.
RESEARCH DESIGN AND METHODS—Seven C-peptide–negative patients with type 1 diabetes (two men and five women) were studied at the General Clinical Research Center at Temple University Hospital two times, 1 month apart. Their plasma glucose was normalized overnight by intravenous infusion of insulin. The next morning, they received subcutaneous injections of either aspart or lispro (9.4 ± 1.9 U) in random order. For the next 4–5 h, their plasma glucose was clamped at ∼5.5 mmol/l with a variable infusion of 20% glucose. The study was terminated after 8 h.
RESULTS—Both insulin analogs produced similar serum insulin levels (250–300 pmol/l) at ∼30 min and disappeared from serum after ∼4 h. Insulin aspart and lispro had similar effects on glucose and fat metabolism. Effects on carbohydrate metabolism (glucose uptake, glucose oxidation, and endogenous glucose production) peaked after ∼2–3 h and disappeared after ∼5–6 h. Effects on lipid metabolism (plasma free fatty acid, ketone body levels, and free fatty acid oxidation) appeared to peak earlier (at ∼2 h) and disappeared earlier (after ∼4 h) than the effects on carbohydrate metabolism.
CONCLUSIONS—We conclude that both insulin aspart and lispro are indistinguishable from each other with respect to blood levels and that they are equally effective in correcting abnormalities in carbohydrate and fat metabolism in patients with type 1 diabetes.
- EGP, endogenous glucose production
- FFA, free fatty acid
- GIR, glucose infusion rate
- GRa, rate of glucose appearance
- GRd, rate of glucose disappearance
Footnotes
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C.H. is on the Educators’ Advisory Boards of the TheraSense Corporation, a manufacturer of blood glucose meters, and Amylin Pharmaceuticals, Inc., a manufacturer of pharmaceuticals related to the treatment of diabetes, and has received honoraria for speaking engagements from Aventis Pharmaceuticals and Disetronic Medical Systems, Inc. G.B. is an advisory panel member for Novo Nordisk, GlaxoSmithKline, and Aventis and has received honoraria for speaking engagements from Novo Nordisk, GlaxoSmithKline, Aventis, and Lilly.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted February 20, 2003.
- Received October 23, 2002.
- DIABETES CARE
