Diabetes Care, Vol 21, Issue 11 1904-1909, Copyright © 1998 by American Diabetes Association

ARTICLES

Improved glycemic control with insulin aspart: a multicenter randomized double-blind crossover trial in type 1 diabetic patients. UK Insulin Aspart Study Group

PD Home, A Lindholm, B Hylleberg and P Round
Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne, UK. philip.home@newcastle.ac.uk

OBJECTIVE: To compare glycemic control obtained with the new rapid-acting insulin analog insulin aspart with that obtained with unmodified human insulin using algorithm-driven dosage adjustment. RESEARCH DESIGN AND METHODS: This was a multicenter randomized double-blind crossover study of 90 male subjects with type 1 diabetes. Insulin aspart or soluble human insulin was administered before meals, and NPH insulin was administered at bedtime as basal therapy. Each 4-week study period ended with a 24-h inpatient serum insulin and plasma glucose profile. RESULTS: The 24-h plasma glucose control obtained with insulin aspart, as assessed by excursions of blood glucose outside a predefined normal range (4.0-7.0 mmo/l), was superior (22% reduction in excursion, P < 0.01). Fructosamine levels remained unchanged with insulin aspart, with daytime glycemic control superior but nighttime glycemic control inferior. Eight-point home blood glucose profiles confirmed that insulin aspart significantly improved postprandial blood glucose control after lunch and dinner (P < 0.05) without deterioration of preprandial blood glucose control. Hypoglycemic episodes requiring third-party intervention were significantly fewer with insulin aspart than with human insulin (20 vs. 44 events, P < 0.002). Insulin aspart was well tolerated. CONCLUSIONS: In comparison with human insulin, insulin aspart can improve postprandial glycemic control as assessed by a reduction in hyper- and hypoglycemic excursions in people with type 1 diabetes. For its full potential to be realized, it will need to provide better control of nighttime hyperglycemia.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				L. Jovanovic and D. J. Pettitt Treatment With Insulin and Its Analogs in Pregnancies Complicated by Diabetes Diabetes Care, July 1, 2007; 30(Supplement_2): S220 - S224. [Full Text] [PDF]

				C. C. Lubitz, J. J. Seley, C. Rivera, N. Sinha, and D. J. Brillon The Perils of Inpatient Hyperglycemia Management: How We Turned Apathy Into Action Diabetes Spectr, January 1, 2007; 20(1): 18 - 21. [Abstract] [Full Text] [PDF]

				K. Rave, O. Klein, A. D. Frick, and R. H.A. Becker Advantage of Premeal-Injected Insulin Glulisine Compared With Regular Human Insulin in Subjects With Type 1 Diabetes Diabetes Care, August 1, 2006; 29(8): 1812 - 1817. [Abstract] [Full Text] [PDF]

				C. Robertson Physiologic insulin replacement in type 2 diabetes: optimizing postprandial glucose control. The Diabetes Educator, May 1, 2006; 32(3): 423 - 432. [Abstract] [Full Text] [PDF]

				J. Plank, A. Siebenhofer, A. Berghold, K. Jeitler, K. Horvath, P. Mrak, and T. R. Pieber Systematic Review and Meta-analysis of Short-Acting Insulin Analogues in Patients With Diabetes Mellitus Arch Intern Med, June 27, 2005; 165(12): 1337 - 1344. [Abstract] [Full Text] [PDF]

				I. B. Hirsch Insulin Analogues N. Engl. J. Med., January 13, 2005; 352(2): 174 - 183. [Full Text] [PDF]

				A. Ceriello Postprandial Hyperglycemia and Diabetes Complications: Is It Time to Treat? Diabetes, January 1, 2005; 54(1): 1 - 7. [Abstract] [Full Text] [PDF]

				A. Ceriello, M. Hanefeld, L. Leiter, L. Monnier, A. Moses, D. Owens, N. Tajima, J. Tuomilehto, and for the International Prandial Glucose Regulation Postprandial Glucose Regulation and Diabetic Complications Arch Intern Med, October 25, 2004; 164(19): 2090 - 2095. [Abstract] [Full Text] [PDF]

				S.A. Saunders, M. Wallymahmed, and I.A. MacFarlane Glycaemic control in a type 1 diabetes clinic for younger adults QJM, September 1, 2004; 97(9): 575 - 580. [Abstract] [Full Text] [PDF]

				R. G. Bretzel, S. Arnolds, J. Medding, and T. Linn A Direct Efficacy and Safety Comparison of Insulin Aspart, Human Soluble Insulin, and Human Premix Insulin (70/30) in Patients With Type 2 Diabetes Diabetes Care, May 1, 2004; 27(5): 1023 - 1027. [Abstract] [Full Text] [PDF]

				K. K. Daugherty Review of Insulin Therapy Journal of Pharmacy Practice, February 1, 2004; 17(1): 10 - 19. [Abstract] [PDF]

				S. A. Westphal and P. J. Palumbo Insulin and Oral Hypoglycemic Agents Should Not Be Used in Combination in the Treatment of Type 2 Diabetes Arch Intern Med, August 11, 2003; 163(15): 1783 - 1785. [Full Text] [PDF]

				C. Homko, A. Deluzio, C. Jimenez, J. W. Kolaczynski, and G. Boden Comparison of Insulin Aspart and Lispro: Pharmacokinetic and metabolic effects Diabetes Care, July 1, 2003; 26(7): 2027 - 2031. [Abstract] [Full Text] [PDF]

				P. E. Cryer, S. N. Davis, and H. Shamoon Hypoglycemia in Diabetes Diabetes Care, June 1, 2003; 26(6): 1902 - 1912. [Abstract] [Full Text] [PDF]

				D. E. DeWitt and I. B. Hirsch Outpatient Insulin Therapy in Type 1 and Type 2 Diabetes Mellitus: Scientific Review JAMA, May 7, 2003; 289(17): 2254 - 2264. [Abstract] [Full Text] [PDF]

				J. Plank, A. Wutte, G. Brunner, A. Siebenhofer, B. Semlitsch, R. Sommer, S. Hirschberger, and T. R. Pieber A Direct Comparison of Insulin Aspart and Insulin Lispro in Patients With Type 1 Diabetes Diabetes Care, November 1, 2002; 25(11): 2053 - 2057. [Abstract] [Full Text] [PDF]

				T. Lindstrom, C. A. Hedman, and H. J. Arnqvist Use of a Novel Double-Antibody Technique to Describe the Pharmacokinetics of Rapid-Acting Insulin Analogs Diabetes Care, June 1, 2002; 25(6): 1049 - 1054. [Abstract] [Full Text] [PDF]

				A. Lindholm, L. B. Jensen, P. D. Home, P. Raskin, B. O. Boehm, and J. Rastam Immune Responses to Insulin Aspart and Biphasic Insulin Aspart in People With Type 1 and Type 2 Diabetes Diabetes Care, May 1, 2002; 25(5): 876 - 882. [Abstract] [Full Text] [PDF]

				B. Bode, R. Weinstein, D. Bell, J. McGill, D. Nadeau, P. Raskin, J. Davidson, R. Henry, W.-C. Huang, and R. R. Reinhardt Comparison of Insulin Aspart With Buffered Regular Insulin and Insulin Lispro in Continuous Subcutaneous Insulin Infusion: A randomized study in type 1 diabetes Diabetes Care, March 1, 2002; 25(3): 439 - 444. [Abstract] [Full Text] [PDF]

				K. L. Herbst and I. B. Hirsch Insulin Strategies for Primary Care Providers Clin. Diabetes, January 1, 2002; 20(1): 11 - 17. [Abstract] [Full Text] [PDF]

				P. E. Cryer and B. P. Childs Negotiating the Barrier of Hypoglycemia in Diabetes Diabetes Spectr, January 1, 2002; 15(1): 20 - 27. [Abstract] [Full Text] [PDF]

				Z. Vajo, J. Fawcett, and W. C. Duckworth Recombinant DNA Technology in the Treatment of Diabetes: Insulin Analogs Endocr. Rev., October 1, 2001; 22(5): 706 - 717. [Abstract] [Full Text] [PDF]

				B. W. Bode and P. Strange Efficacy, Safety, and Pump Compatibility of Insulin Aspart Used in Continuous Subcutaneous Insulin Infusion Therapy in Patients With Type 1 Diabetes Diabetes Care, January 1, 2001; 24(1): 69 - 72. [Abstract] [Full Text]

				Z. Vajo and W. C. Duckworth Genetically Engineered Insulin Analogs: Diabetes in the New Millenium Pharmacol. Rev., March 1, 2000; 52(1): 1 - 10. [Abstract] [Full Text] [PDF]

				A. Plum, H. Agersø, and L. Andersen Pharmacokinetics of the Rapid-Acting Insulin Analog, Insulin Aspart, in Rats, Dogs, and Pigs, and Pharmacodynamics of Insulin Aspart in Pigs Drug Metab. Dispos., February 1, 2000; 28(2): 155 - 160. [Abstract] [Full Text]