Counterregulatory hormone responses after long-term continuous subcutaneous insulin infusion with lispro insulin

Diabetes Care
E TsuiB Zinman

Abstract

To determine whether the long-term use of insulin lispro (LP) affects the counterregulatory hormone response to hypoglycemia. Ten patients (age range 26-51 years; ratio of men to women 9:1; BMI 24.9 +/- 0.48; mean HbA1c 7.84 +/- 0.25%) with IDDM, treated with continuous subcutaneous insulin infusion (CSII; Disetronic H-TRON V100) were studied using a double-blind, crossover design. Patients were randomized to LP or human regular insulin (HR) for 3 months and then crossed over to the other insulin for an additional 3 months. All meal boluses were given 0-5 min before breakfast, lunch, and dinner. Counterregulatory hormone responses to a stepped hypoglycemic clamp (consecutive glucose levels in mmol/l: 4.2; 3.5; 2.8, each for 1 h) were evaluated at the end of each treatment period. HbA1c was significantly lower with LP versus HR (7.47 +/- 0.28% vs. 7.9 +/- 0.26%, P = 0.04). The incidence of hypoglycemia per 30 days (capillary blood glucose < 3.0 mmol/l and/or symptoms) during the last month of the study was significantly lower with LP versus HR (8.7 +/- 2.9 vs. 11.8 +/- 2.9, P = 0.03). The total daily insulin dosage was not different in the two treatment periods. There was no episode of severe hypoglycemia or diabetic ketoacidosi...Continue Reading

Citations

Aug 4, 1999·Journal of Diabetes and Its Complications·L Heinemann
Apr 1, 2002·The Physician and Sportsmedicine·Sheri R Colberg, John Walsh
Sep 13, 2001·Diabetic Medicine : a Journal of the British Diabetic Association·S TupolaI Sipilä
Aug 4, 2009·Diabetes Research and Clinical Practice·Iben Brock JacobsenH Beck-Nielsen
Apr 21, 2006·The Cochrane Database of Systematic Reviews·A SiebenhoferT R Pieber

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