Diabetes Care, Vol 23, Issue 5 583-588, Copyright © 2000 by American Diabetes Association

ARTICLES

Use of insulin aspart, a fast-acting insulin analog, as the mealtime insulin in the management of patients with type 1 diabetes

P Raskin, RA Guthrie, L Leiter, A Riis and L Jovanovic
Southwestern Medical Center at Dallas, University of Texas, 75390-8858, USA.

OBJECTIVE: To compare long-term glycemic control and safety of using insulin aspart (IAsp) with that of regular human insulin (HI). RESEARCH DESIGN AND METHODS: This was a multicenter randomized open-label 6-month study (882 subjects) with a 6-month extension period (714 subjects) that enrolled subjects with type 1 diabetes. Subjects administered IAsp immediately before meals or regular HI 30 min before meals; basal NPH insulin was taken as a single bedtime dose in the majority of subjects. Glycemic control was assessed with HbA1c values and 8-point blood glucose profiles at 3-month intervals. RESULTS: Mean postprandial blood glucose levels (mg/dl +/- SEM) were significantly lower for subjects in the IAsp group compared with subjects in the HI group after breakfast (156 +/- 3.4 vs. 185 +/- 4.7), lunch (137 +/- 3.1 vs. 162 +/- 4.1), and dinner (153 +/- 3.1 vs. 168 +/- 4.1), when assessed after 6 months of treatment. Mean HbA1c values (% +/- SEM) were slightly, but significantly, lower for the IAsp group (7.78% +/- 0.03) than for the regular HI group (7.93% +/- 0.05, P = 0.005) at 6 months. Similar postprandial blood glucose and HbA1c values were observed at 12 months. Adverse events and overall hypoglycemic episodes were similar for both treatment groups. CONCLUSIONS: Postprandial glycemic control was significantly better with IAsp compared with HI after 6 and 12 months of treatment. The improvement was not obtained at an increased risk of hypoglycemia. HbA1c was slightly, but significantly, lower for IAsp compared with HI at 6 and 12 months.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. E. Fineberg, T. T. Kawabata, D. Finco-Kent, R. J. Fountaine, G. L. Finch, and A. S. Krasner Immunological Responses to Exogenous Insulin Endocr. Rev., October 1, 2007; 28(6): 625 - 652. [Abstract] [Full Text] [PDF]

				E. R. Mathiesen, B. Kinsley, S. A. Amiel, S. Heller, D. McCance, S. Duran, S. Bellaire, A. Raben, and on behalf of the Insulin Aspart Pregnancy Study Gr Maternal Glycemic Control and Hypoglycemia in Type 1 Diabetic Pregnancy: A randomized trial of insulin aspart versus human insulin in 322 pregnant women Diabetes Care, April 1, 2007; 30(4): 771 - 776. [Abstract] [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]

				F. M Regan and D. B Dunger Use of new insulins in children Arch. Dis. Child. Ed. Pract., August 1, 2006; 91(2): ep47 - ep53. [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]

				S. S. Braithwaite Case Study: Five Steps to Freedom: Dose Titration for Type 2 Diabetes Using Basal-Prandial-Correction Insulin Therapy Clin. Diabetes, January 1, 2005; 23(1): 39 - 43. [Full Text] [PDF]

				C. L. Thompson, K. C. Dunn, M. C. Menon, L. E. Kearns, and S. S. Braithwaite Hyperglycemia in the Hospital Diabetes Spectr, January 1, 2005; 18(1): 20 - 27. [Abstract] [Full Text] [PDF]

				R. Retnakaran, J. Hochman, J. H. DeVries, H. Hanaire-Broutin, R. J. Heine, V. Melki, and B. Zinman Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections: The impact of baseline A1c Diabetes Care, November 1, 2004; 27(11): 2590 - 2596. [Abstract] [Full Text] [PDF]

				G. Dailey, J. Rosenstock, R. G. Moses, and K. Ways Insulin Glulisine Provides Improved Glycemic Control in Patients With Type 2 Diabetes Diabetes Care, October 1, 2004; 27(10): 2363 - 2368. [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]

				S. Clement, S. S. Braithwaite, M. F. Magee, A. Ahmann, E. P. Smith, R. G. Schafer, and I. B. Hirsch Management of Diabetes and Hyperglycemia in Hospitals Diabetes Care, February 1, 2004; 27(2): 553 - 591. [Full Text] [PDF]

				B. Ahmad Review: Pharmacology of insulin The British Journal of Diabetes & Vascular Disease, January 1, 2004; 4(1): 10 - 14. [Abstract] [PDF]

				T. Danne, J. Aman, E. Schober, D. Deiss, J. L. Jacobsen, H. H. Friberg, and L. H. Jensen A Comparison of Postprandial and Preprandial Administration of Insulin Aspart in Children and Adolescents With Type 1 Diabetes Diabetes Care, August 1, 2003; 26(8): 2359 - 2364. [Abstract] [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]

				J. H. DeVries, F. J. Snoek, P. J. Kostense, N. Masurel, and R. J. Heine A Randomized Trial of Continuous Subcutaneous Insulin Infusion and Intensive Injection Therapy in Type 1 Diabetes for Patients With Long-Standing Poor Glycemic Control Diabetes Care, November 1, 2002; 25(11): 2074 - 2080. [Abstract] [Full Text] [PDF]

				D. I. Becker Pediatric Use of Insulin Pumps: Longer Infusion Site Lifetime With NovoLog Diabetes Care, September 1, 2002; 25(9): 1663 - 1663. [Full Text]

				J H. DeVries and R. J Heine Insulin pumps are still debatable for type 1 diabetes BMJ, July 6, 2002; 325(7354): 46 - 46. [Full Text]

				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]

				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]