Efficacy of a Continuous GLP-1 Infusion Compared With a Structured Insulin Infusion Protocol to Reach Normoglycemia in Nonfasted Type 2 Diabetic Patients: A Clinical Pilot Trial
- Harald Sourij, MD1,2,
- Isabella Schmölzer, MD2,3,
- Eva Kettler-Schmut, MD2,
- Michaela Eder, MD1,2,
- Helga Pressl, MD3,
- Antonella deCampo, MD3 and
- Thomas C. Wascher, MD2,4
- 1Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
- 2Metabolism and Vascular Biology Research Group, Department of Internal Medicine, Medical University of Graz, Graz, Austria;
- 3Department of Internal Medicine, Medical University of Graz, Graz, Austria;
- 41st Department of Internal Medicine, Hanusch Hospital, Vienna, Austria.
- Corresponding author: Thomas C. Wascher, thomas.wascher{at}medunigraz.at.
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H.S. and I.S. contributed equally to this work.
Abstract
OBJECTIVE Continuously administered insulin is limited by the need for frequent blood glucose measurements, dose adjustments, and risk of hypoglycemia. Regimens based on glucagon-like peptide 1 (GLP-1) could represent a less complicated treatment alternative. This alternative might be advantageous in hyperglycemic patients hospitalized for acute critical illnesses, who benefit from near normoglycemic control.
RESEARCH DESIGN AND METHODS In a prospective open randomized crossover trial, we investigated eight clinically stable type 2 diabetic patients during intravenous insulin or GLP-1 regimens to normalize blood glucose after a standardized breakfast.
RESULTS The time to reach a plasma glucose below 115 mg/dl was significantly shorter during GLP-1 administration (252 ± 51 vs. 321 ± 43 min, P < 0.01). Maximum glycemia (312 ± 51 vs. 254 ± 48 mg/dl, P < 0.01) and glycemia after 2 h (271 ± 51 vs. 168 ± 48 mg/dl, P = 0.012) and after 4 h (155 ± 51 vs. 116 ± 27 mg/dl, P = 0.02) were significantly lower during GLP-1 administration.
CONCLUSIONS GLP-1 infusion is superior to an established insulin infusion regimen with regard to effectiveness and practicability.
Footnotes
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Clinical trial registry no. NCT00859079, clinicaltrials.gov.
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received March 10, 2009.
- Accepted May 30, 2009.
- © 2009 by the American Diabetes Association.
