Post-prandial administration of the insulin analogue insulin aspart in patients with Type 1 diabetes mellitus

  1. G. A. Brunner1,
  2. S. Hirschberger2,
  3. G. Sendlhofer1,
  4. A. Wutte1,
  5. M. Ellmerer1,
  6. B. Balent1,
  7. L. Schaupp1,
  8. G. J. Krejs1,
  9. T. R. Pieber1

Article first published online: 24 DEC 2001

DOI: 10.1046/j.1464-5491.2000.00289.x

Issue

Diabetic Medicine

Diabetic Medicine

Volume 17, Issue 5, pages 371–375, May 2000

Additional Information

How to Cite

Brunner, G. A., Hirschberger, S., Sendlhofer, G., Wutte, A., Ellmerer, M., Balent, B., Schaupp, L., Krejs, G. J. and Pieber, T. R. (2000), Post-prandial administration of the insulin analogue insulin aspart in patients with Type 1 diabetes mellitus. Diabetic Medicine, 17: 371–375. doi: 10.1046/j.1464-5491.2000.00289.x

Author Information

  1. 1

    Department of Internal Medicine, Karl-Franzens University, Graz, Austria

  2. 2

    Novo Nordisk A/S Germany

* Dr Gernot A. Brunner, Department of Internal Medicine, Karl-Franzens University, Auenbruggerplatz 15, A−8036 Graz, Austria. E-mail: gernot.brunner@kfunigraz.ac.at

Publication History

  1. Issue published online: 24 DEC 2001
  2. Article first published online: 24 DEC 2001
  3. Received 2 September 1999; revised 7 February 2000; accepted 13 March 2000

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Keywords:

  • injection–meal interval;
  • insulin analogue;
  • insulin aspart;
  • insulin therapy;
  • soluble human insulin

Summary

Aims In intensified insulin therapy, the recent development of short-acting insulin analogues with a very rapid onset of action forces a new discussion in terms of the optimal injection–meal interval. This study evaluated prandial glycaemia in patients with Type 1 diabetes following the subcutaneous injection of soluble human insulin (HI) and the insulin analogue insulin aspart (IAsp) at different injection–meal intervals and investigated whether administration of IAsp after the meal might provide satisfactory metabolic control.

Methods In a randomized, double-blind, double-dummy, four-period crossover study, 20 Type 1 diabetic patients were investigated. Prandial insulin was administered 15 min before the start of the meal (HI(−15min)), immediately before the meal (HI(0min); IAsp(0min)) and 15 min after the start of the meal (IAsp(+15min)).

Results Plasma glucose excursions from baseline levels during the 4 h (PGexc) were highest with HI(0min) (17.9 mmol.l−1.h; P < 0.05 vs. other treatments) and were not statistically different for HI(−15min), IAsp(0min) and IAsp(15min) (13.6, 11.9 and 14.2 mmol.l−1.h, respectively). Maximum concentration of plasma glucose (PGmax) was lowest with IAsp(0min) (11.2 mmol/l; P < 0.05 vs. other treatments). PGmax was comparable with HI(−15min), HI(0min) and IAsp(+15min) (13.3, 14.1 and 13.2 mmol/l, respectively).

Conclusions With regard to prandial glycaemia IAsp(+15min) is as effective as HI(− 5min) and superior to HI(0min). Thus, post-prandial dosing of the insulin analogue IAsp offers an attractive and feasible therapeutic option for well-controlled patients with Type 1 diabetes mellitus.

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