Effect of Insulin Glulisine on Microvascular Blood Flow and Endothelial Function in the Postprandial State
- Clothilde Hohberg, MD1,
- Thomas Forst, MD (thomasf{at}ikfe.de)1,,2,
- Martin Larbig, PhD3,
- Michael Safinowski, PhD1,
- Stefan Diessel, MD1,
- Silvia Hehenwarter1,
- Matthias M. Weber, MD2,
- Thomas Schöndorf, PhD1 and
- Andreas Pfützner, MD, PhD1
- 1Institute for Clinical Research and Development, Mainz, Germany
- 2Johannes Gutenberg University, Dept. Endocrinology, Mainz, Germany
- 3sanofi-aventis, Berlin, Germany
Abstract
OBJECTIVE: To investigate the effect of insulin glulisine on postprandial microvascular blood flow in T2DM.
RESEARCH DESIGN AND METHODS: Fifteen patients with T2DM received insulin glulisine or human insulin before a liquid meal test. Thereafter, skin microvascular blood flow was measured by the use of laser Doppler fluxmetry (LDF), and blood samples were taken for the meaurement of plasma levels of glucose, insulin, intact proinsulin, ADMA, nitrotyrosine, IL-18, MMP-9, oxLDL, and FFA.
RESULTS: Insulin glulisine resulted in higher postpradial insulin levels (mean±SEM; AUC0–120:51.0±6.8 vs. 38.2±5.4 mU/L; p=0.004), while plasma glucose (AUC0–240: 158±9 vs. 180±9 mg/dl; p<0.05) and intact proinsulin (AUC0–240: 26.2±3.5 vs 31.2±4.3 pmol/L; p=0.002) were lower. Microvascular blood flow increased after insulin glulisine (27.9±3.1 to 51.7±9.9 AU; p<0.05), while only a minor increase was found during human insulin (27.9±3.1 to 34.4±7.8; n.s.). ADMA and Nitrotyrosine levels were reduced after insulin glulisine (p<0.05, respectively).
CONCLUSIONS: Insulin glulisine is superior to human insulin in restoring postprandial metabolic and microvascular physiology.
Footnotes
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- Received November 29, 2007.
- Accepted February 2, 2008.
- Copyright © American Diabetes Association
