Better long‐term glycaemic control with the basal insulin glargine as compared with NPH in patients with Type 1 diabetes mellitus given meal‐time lispro insulin

Porcellati, Francesca; Rossetti, Paolo; Pampanelli, S.; Fanelli, Carmine G.; Torlone, Elisabetta; Scionti, L.; Perriello, G.; Bolli, Geremia B.

doi:10.1111/j.1464-5491.2004.01323.x

Cited by 115 publications

(69 citation statements)

References 30 publications

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“…In the clinical setting, this translates into lower risk of nocturnal hypoglycemia (10 -13), lower A1C (provided that appropriate requirements of mealtime rapid-acting insulin are met) (11)(12)(13), and the convenience of once (12), compared with multiple, administration of NPH (14). However, no study has examined subjects after several days of its use versus the "first" subcutaneous injection.…”

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confidence: 99%

Pharmacokinetics and Pharmacodynamics of the Long-Acting Insulin Analog Glargine After 1 Week of Use Compared With Its First Administration in Subjects With Type 1 Diabetes

et al. 2007

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confidence: 99%

Pharmacokinetics and Pharmacodynamics of the Long-Acting Insulin Analog Glargine After 1 Week of Use Compared With Its First Administration in Subjects With Type 1 Diabetes

et al. 2007

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“…This more physiological substitution translates into clinical benefits compared with NPH, primarily a reduced risk of nocturnal hypoglycemia for similar A1C levels (1)(2)(3)(4)(5)(6)(7).…”

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Pharmacokinetics and Pharmacodynamics of Insulin Glargine Given in the Evening as Compared With in the Morning in Type 2 Diabetes

et al. 2014

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OBJECTIVETo compare pharmacokinetics (PK) and pharmacodynamics (PD) of insulin glargine in type 2 diabetes mellitus (T2DM) after evening versus morning administration. RESEARCH DESIGN AND METHODSTen T2DM insulin-treated persons were studied during 24-h euglycemic glucose clamp, after glargine injection (0.4 units/kg s.c.), either in the evening (2200 h) or the morning (1000 h). RESULTSThe 24-h glucose infusion rate area under the curve (AUC 0-24h ) was similar in the evening and morning studies (1,058 6 571 and 995 6 691 mg/kg 3 24 h, P = 0.503), but the first 12 h (AUC 0-12h ) was lower with evening versus morning glargine (357 6 244 vs. 593 6 374 mg/kg 3 12 h, P = 0.004), whereas the opposite occurred for the second 12 h (AUC 12-24h 700 6 396 vs. 403 6 343 mg/kg 3 24 h, P = 0.002). The glucose infusion rate differences were totally accounted for by different rates of endogenous glucose production, not utilization. Plasma insulin and C-peptide levels did not differ in evening versus morning studies. Plasma glucagon levels (AUC 0-24h 1,533 6 656 vs. 1,120 6 344 ng/L/h, P = 0.027) and lipolysis (free fatty acid AUC 0-24h 7.5 6 1.6 vs. 8.9 6 1.9 mmol/L/h, P = 0.005; b-OH-butyrate AUC 0-24h 6.8 6 4.7 vs. 17.0 6 11.9 mmol/L/h, P = 0.005; glycerol, P < 0.020) were overall more suppressed after evening versus morning glargine administration. CONCLUSIONSThe PD of insulin glargine differs depending on time of administration. With morning administration insulin activity is greater in the first 0-12 h, while with evening administration the activity is greater in the 12-24 h period following dosing. However, glargine PK and plasma C-peptide levels were similar, as well as glargine PD when analyzed by 24-h clock time independent of the time of administration. Thus, the results reflect the impact of circadian changes in insulin sensitivity in T2DM (lower in the night-early morning vs. afternoon hours) rather than glargine per se.

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“…Entretanto, a incidência de episódios hipoglicêmicos noturnos foi 43% menor no grupo com os análogos. Na prática, a maior previsibilidade destes análogos é traduzida pelo menor risco de episódios graves de hipoglicemias, principalmente no período noturno (14,30).…”

Section: Insulinoterapia Em Dm1unclassified

A evolução da insulinoterapia no diabetes melito tipo 1

Pires

Chacra

2008

Arq Bras Endocrinol Metab

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RESuMOA descoberta da insulina foi o grande marco da história do diabetes melito e a grande conquista para o seu tratamento. A primeira insulina disponibilizada foi a regular. na seqüência, Hagedorn acrescentou a protamina à insulina, criando, assim, a insulina nPH. na década de 1950 foi sintetizada uma insulina desprovida de protamina, denominada insulina lenta. com o advento da biologia molecular, sintetizou-se, via dnA recombinante, a insulina humana sintética. Mais recentemente, foram disponibilizados vários tipos de análo-gos de insulina que permitiram o melhor controle metabólico dos pacientes. o tratamento do diabetes melito tipo 1, além do processo educacional, incluindo a prática regular de atividades físicas e orientações dietéticas, resumese na substituição plena de insulina de longa e curta durações de ação, de maneira individualizada, de acordo com a experiência do médico-assistente. no diabetes melito tipo 1, a preferência é pelas insulinas de menor variabilidade, por meio do esquema basal/bólus ou pelas bombas de infusão contí-nua de insulina subcutânea com o objetivo de mimetizar a liberação fisiológica de insulina pelas células-β. ABStRAct insulin therapy for type 1 Diabetes Mellitus: past and present. the discovery of insulin can be considered the milestone of diabetes mellitus history and a great achievement for its treatment. the first insulin available was the regular. Afterwards, Hagedorn added the protamine to the insulin, thus, creating the nPH insulin. in the 1950s an insulin free of protamine was synthesized: the lente insulin. With the advent of molecular biology, synthetic human insulin was synthesized using recombinant dnA technology. Most recently several types of insulin analogues were available, providing the patients with better metabolic control. type 1 diabetes mellitus treatment includes plain substitution and individualization for short-acting plus long-acting insulin according to the physician's assistance, besides regular practice of physical activities and diet orientations. in type 1 diabetes mellitus the insulin of low variability is the best choice since basal/bolus insulin therapy or continuous subcutaneous insulin infusion pump can mimetize the physiological release of insulin by β cells.

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Better long‐term glycaemic control with the basal insulin glargine as compared with NPH in patients with Type 1 diabetes mellitus given meal‐time lispro insulin

Abstract: The simpler glargine regimen decreases the percentage of HbA(1c) and frequency of hypoglycaemia and improves responses to hypoglycaemia more than NPH. Thus, glargine appears more suitable than NPH as basal insulin for intensive treatment of T1 DM.

Cited by 115 publications

References 30 publications

Pharmacokinetics and Pharmacodynamics of the Long-Acting Insulin Analog Glargine After 1 Week of Use Compared With Its First Administration in Subjects With Type 1 Diabetes

Pharmacokinetics and Pharmacodynamics of the Long-Acting Insulin Analog Glargine After 1 Week of Use Compared With Its First Administration in Subjects With Type 1 Diabetes

Pharmacokinetics and Pharmacodynamics of Insulin Glargine Given in the Evening as Compared With in the Morning in Type 2 Diabetes

A evolução da insulinoterapia no diabetes melito tipo 1

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