Diabetes Care, Vol 21, Issue 5 800-803, Copyright © 1998 by American Diabetes Association
Time-action profiles of novel premixed preparations of insulin lispro and NPL insulin
T Heise, C Weyer, A Serwas, S Heinrichs, J Osinga, P Roach, J Woodworth, U Gudat and L Heinemann
Department of Metabolic Diseases and Nutrition, World Health Organization Collaborating Center for Diabetes, Heinrich-Heine-University of Dusseldorf, Germany.
OBJECTIVE: To study the pharmacodynamic properties of three premixed
formulations of the rapid-acting insulin analog insulin lispro and its
protamine-retarded preparation, neutral protamine lispro (NPL) insulin.
RESEARCH DESIGN AND METHODS: In this open, single-center, euglycemic
glucose clamp study, 30 healthy volunteers (12 women, 18 men) aged 27 +/- 2
years (mean +/- SD), whose BMI was 23.0 +/- 2.3 kg/m2, received
subcutaneous injections of 0.3 U/kg body wt of insulin mixture
(high-mixture 75/25, mid-mixture 50/50, or low-mixture 25/75 insulin
lispro/NPL insulin), insulin lispro, or NPL insulin on one of the five
study days in randomized order. Glucose infusion rates were determined over
a period of 24 h after administration. RESULTS: Maximal metabolic activity
decreased after subcutaneous injection of the mixtures with lower insulin
lispro content; however, the time point of maximal and of early
half-maximal metabolic activity was comparable among the three mixtures.
Higher proportions of insulin lispro resulted in higher values for area
under the curve within the first 360 min after injection and a more rapid
decline to late half-maximal activity. Serum insulin concentrations showed
a similar pattern. CONCLUSIONS: This study shows that the pharmacodynamic
and pharmacokinetic properties of insulin lispro are preserved in stable
mixtures with NPL insulin.