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Research Article
Severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia: a comparative study of insulin lispro and regular human insulin
Article first published online: 20 JUN 2001
DOI: 10.1002/dmrr.202
Copyright © 2001 John Wiley & Sons, Ltd.
1520-7560/asset/cover.gif?v=1&s=518ef24df4af0f53197d5b36e1afedd4421360a2 "Diabetes/Metabolism Research and Reviews")
Additional Information
How to Cite
Ferguson, S. C., Strachan, M. W. J., Janes, J. M. and Frier, B. M. (2001), Severe hypoglycaemia in patients with type 1 diabetes and impaired awareness of hypoglycaemia: a comparative study of insulin lispro and regular human insulin. Diabetes/Metabolism Research and Reviews, 17: 285–291. doi: 10.1002/dmrr.202
Publication History
- Issue published online: 14 AUG 2001
- Article first published online: 20 JUN 2001
- Manuscript Accepted: 12 APR 2001
- Manuscript Revised: 6 APR 2001
- Manuscript Received: 12 DEC 2000
Funded by
- Eli Lilly & Company Ltd
- Abstract
- Article
- References
- Cited By
Keywords:
- type 1 diabetes;
- insulin lispro;
- hypoglycaemia unawareness;
- hypoglycaemia
Abstract
Objective
To assess the potential of insulin lispro to limit the frequency of severe hypoglycaemia without compromising glycaemic control in a cohort of patients with type 1 diabetes who are at a high risk of severe hypoglycemia.
Research design and methods
An open-label, randomised, 12-month comparative crossover study of insulin lispro and regular human insulin was performed in 33 patients with type 1 diabetes with impaired hypoglycaemia awareness. The efficacy of each treatment was evaluated by glycaemic control (HbA1c), eight-point home blood glucose profiles, and the frequency and severity of hypoglycaemic episodes and quality of life.
Results
Eighteen (55%) patients experienced one or more episodes of severe hypoglycaemia in the 48 weeks of study. There was a trend to a lower incidence of severe hypoglycaemia during treatment with insulin lispro in comparison with regular human insulin (55 vs 84 episodes, p=0.087). This resulted principally from a 47% lower incidence of nocturnal severe hypoglycaemia with insulin lispro (25 vs 47 episodes, p=0.11). The lower frequency of severe hypoglycaemia associated with insulin lispro was not explained by differences in glycated haemoglobin between insulin treatments (HbA1c 9.1% insulin lispro vs 9.3% regular human insulin).
Conclusions
In individuals with type 1 diabetes, who have impaired awareness of hypoglycaemia, treatment with insulin lispro may be associated with a lower incidence of severe hypoglycaemia manifested predominantly through less frequent nocturnal episodes. Insulin lispro may have a beneficial role in the management of patients with diabetes at risk of severe hypoglycaemia, although a larger study is required to confirm these findings. Copyright © 2001 John Wiley & Sons, Ltd.