Efficacy of a continuous GLP-1 infusion compared to a structured insulin infusion protocol to reach normoglycemia in non-fasted type 2 diabetic patients – A clinical pilot trial
- Harald Sourij, MD1,2,
- Isabella Schmoelzer, MD2,3,
- Eva Kettler-Schmut, MD2,
- Michaela Eder1,2,
- Helga Pressl3,
- Antonella deCampo3 and
- Thomas C. Wascher, MD (thomas.wascher{at}medunigraz.at)2,4
- 1 Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Austria
- 2 Metabolism and Vascular Biology Research Group, Medical University of Graz, Austria
- 3 Department of Internal Medicine, Medical University of Graz, Austria
- 4 1st Department of Medicine, Hanusch-Hospital, Vienna, Austria
Abstract
Objective: Continuously administered insulin is limited by the need for frequent blood glucose measurements, dose adaption and risk of hypoglycemia. Alternatively, GLP-1-based regimens could represent a less complicated treatment alternative. This might be advantageous in hyperglycemic patients hospitalized for acute critical illness that profit from near normoglycemic control.
Research Design and Methods: In a prospective, open, randomised, crossover trial we investigated 8 clinically stable type 2 diabetic patients during an intravenous insulin or GLP-1regimen to normalize blood glucose after a standardized breakfast.
Results: 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), glycemia after 2 hours (271±51 vs. 168±48 mg/dl, p=0.012) and after 4 hours (155±51 vs. 116±27 md/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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- Received March 10, 2009.
- Accepted May 30, 2009.
- Copyright © American Diabetes Association
