Postprandial glycemic control with biphasic insulin aspart in patients with type 1 diabetes

• Published in: Metabolism, clinical and experimental Vol. 51; no. 7; pp. 896 - 900
• Main Authors: Hermansen, Kjeld, Vaaler, Stein, Madsbad, Sten, Dalgaard, Marian, Zander, Mette, Begtrup, Kamilla, Soendergaard, Karsten
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2002; Elsevier
• Subjects: Adult; Area Under Curve; Associated diseases and complications; Biological and medical sciences; Biphasic Insulins; Blood Glucose - drug effects; Cross-Over Studies; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Diabetes. Impaired glucose tolerance; Dosage Forms; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Fatty Acids, Nonesterified - blood; Hormones. Endocrine system; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - pharmacokinetics; Injections, Subcutaneous; Insulin - administration & dosage; Insulin - adverse effects; Insulin - analogs & derivatives; Insulin - pharmacokinetics; Insulin Aspart; Insulin, Isophane; Medical sciences; Pharmacology. Drug treatments; Postprandial Period - drug effects; Treatment Outcome; Triglycerides - blood; Endocrinopathy; Human; Immunopathology; Replacement therapy; Insulin human; Treatment efficiency; Autoimmune disease; Metabolic diseases; Lipids; Chemotherapy; Hyperglycemia; Hypoglycemic agent; Insulin dependent diabetes; Insulin aspart; Adult; Hyperlipemia; Biphasic insulin injection; Dyslipemia; Comparative study; Glycemia
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1053/meta.2002.33358

We sought to investigate the ability of biphasic insulin aspart 30 (BIAsp 30) to control postprandial hyperglycemia and hyperlipidemia in a meal-test comparison with biphasic human insulin 30 (BHI 30). In this randomised crossover trial, 50 patients with type 1 diabetes (mean age, 35.7 [plusmn] 9.4 years; body mass index [BMI], 24.0 [plusmn] 2.6 kg/m
2; HbA
1c, 8.6% [plusmn] 1.1%) were studied on 3 separate days, where the following treatments were given in random order: BIAsp 30 injected immediately before a standard breakfast, BHI 30 injected 30 minutes before breakfast (BHI 30
t=[minus ]30), and BHI 30 injected immediately before breakfast (BHI 30
t=0). The dose was 0.40 U/kg for all 3 treatments. BIAsp 30 reduced the area under the baseline adjusted 4-hour postprandial serum glucose curve (AUC
0-4h) by 23% compared with BHI 30
t=0 (
P [lt ] .0001) and by 9% compared with BHI 30
t=[minus ]30 (
P = .013). Maximum serum glucose concentration (C
max) was lower for BIAsp 30 compared with BHI 30
t=0 (14.0 [plusmn] 2.4
v 16.5 [plusmn] 2.8 mmol/L,
P [lt ] .0001), and time to maximal serum glucose concentration (t
max) was approximately 20 minutes shorter for BIAsp 30, irrespective of timing of BHI 30 injection (
P [lt ] .0001). There were no significant differences among the 3 treatments with respect to postprandial levels of free fatty acids or triglycerides. The pharmacokinetic results were consistent with the above observations, ie, significantly larger insulin AUC
0-4h, higher C
max and shorter t
max were observed for BIAsp 30 compared with BHI 30, irrespective of timing of BHI 30 injection. We conclude that postprandial glycemic control was more effective with BIAsp 30 than with BHI 30, irrespective of timing of BHI 30 injection.