Lispro Is Superior to Regular Insulin in Transient Intensive Insulin Therapy in Type 2 Diabetes

この論文にアクセスする

この論文をさがす

著者

抄録

金沢大学大学院医学系研究科 Objective. The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context. Patients and Methods. To explore this possibility, we compared the effect on β- and α-cell function of transient intensive insulin therapy using lispro versus human regular insulin in a total of 21 type 2 diabetic patients who were randomly assigned to 14-days intensive insulin therapy consisting of bedtime NPH insulin plus three injections of mealtime lispro (n=11) or regular insulin (n=10). The dosages of both types of insulin were adjusted to attain preprandial glucose levels of <6.1 mmol/l within 1 week with similar rates of glucose decline. An oral glucose tolerance test (OGTT) was performed at day 0 (baseline), 7, and 14; plasma glucose, serum insulin, and plasma glucagon responses over 0-120 minutes were measured, and calculated as the area under the curve (AUC). Results. Lispro led to a significant reduction in glucose-AUC and also an increase in insulin-AUC versus regular insulin on day 7. Glucagon secretion following OGTT was well suppressed with lispro on day 14 compared to regular insulin. Conclusion. Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid β-cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits.

  <i><b>Objective</b></i>  The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context.<br>  <i><b>Patients and Methods</b></i>  To explore this possibility, we compared the effect on β- and α-cell function of transient intensive insulin therapy using lispro versus human regular insulin in a total of 21 type 2 diabetic patients who were randomly assigned to 14-days intensive insulin therapy consisting of bedtime NPH insulin plus three injections of mealtime lispro (n=11) or regular insulin (n=10). The dosages of both types of insulin were adjusted to attain preprandial glucose levels of <6.1 mmol/<i>l</i> within 1 week with similar rates of glucose decline. An oral glucose tolerance test (OGTT) was performed at day 0 (baseline), 7, and 14; plasma glucose, serum insulin, and plasma glucagon responses over 0-120 minutes were measured, and calculated as the area under the curve (AUC).<br>  <i><b>Results</b></i>  Lispro led to a significant reduction in glucose-AUC and also an increase in insulin-AUC versus regular insulin on day 7. Glucagon secretion following OGTT was well suppressed with lispro on day 14 compared to regular insulin.<br>  <i><b>Conclusion</b></i>  Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid β-cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits.

収録刊行物

  • Internal medicine

    Internal medicine 43(9), 779-786, 2004-09-01

    日本内科学会

参考文献:  41件中 1-41件 を表示

各種コード

  • NII論文ID(NAID)
    10013571478
  • NII書誌ID(NCID)
    AA10827774
  • 本文言語コード
    ENG
  • 資料種別
    ART
  • ISSN
    09182918
  • NDL 記事登録ID
    7095541
  • NDL 雑誌分類
    ZS21(科学技術--医学--内科学)
  • NDL 請求記号
    Z53-M398
  • データ提供元
    CJP書誌  NDL  IR  J-STAGE 
ページトップへ