Optimal dose and timing of insulin Aspart to mimic first phase insulin response in patients with recently onset type 2 diabetes

Gredal, Charlotte; Rosenfalck, A.; Dejgaard, A.; Hilsted, J.

doi:10.1016/j.diabres.2007.12.023

Cited by 5 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dose timing may be less critical in people with Type 2 diabetes, at least while they retain useful amounts of endogenous insulin. A study by Gredal et al [42] assessed the optimal dose and timing of aspart in people with Type 2 diabetes. No difference in postprandial glucose profile was demonstrated whether insulin aspart 0.04 IU/kg was administrated 15 or 30 min before mealtime.…”

Section: Evidence From Clinical Studiesmentioning

confidence: 99%

Optimal prandial timing of bolus insulin in diabetes management: a review

2017

View full text Add to dashboard Cite

The inability to achieve optimal diabetes glucose control in people with diabetes is multifactorial, but one contributor may be inadequate control of postprandial glucose. In patients treated with multiple daily injections of insulin, both the dose and timing of meal‐related rapid‐acting insulin are key factors in this. There are conflicting opinions and evidence on the optimal time to administer mealtime insulin. We performed a comprehensive literature search to review the published data, focusing on the use of rapid‐acting insulin analogues in patients with Type 1 diabetes. Pharmacokinetic and pharmacodynamic studies of rapid‐acting insulin analogues, together with postprandial glucose excursion data, suggest that administering these 15–20 min before food would provide optimal postprandial glucose control. Data from clinical studies involving people with Type 1 diabetes receiving structured meals and rapid‐acting insulin analogues support this, showing a reduction in post‐meal glucose levels of ~30% and less hypoglycaemia when meal insulin was taken 15–20 min before a meal compared with immediately before the meal. Importantly, there was also a greater risk of postprandial hypoglycaemia when patients took rapid‐acting analogues after eating compared with before eating.

show abstract

Section: Evidence From Clinical Studiesmentioning

confidence: 99%

Optimal prandial timing of bolus insulin in diabetes management: a review

2017

View full text Add to dashboard Cite

show abstract

“…Insulin Aspart (IAsp) is a rapidly acting insulin analogue that is rapidly absorbed after subcutaneous administration; it has twice the maximal concentration and takes half the time to reach the maximal concentration, resulting in better glycaemic control, compared to equivalent doses of regular insulin [12,13]. In a single-dose study in patients with early type 2 diabetes, we demonstrated that a very low dose of IAsp (0.04-0.08 IU/kg BW) injected 30 min before meals significantly reduced the PPG increment compared to placebo [14]. However, results collected from a single dose study in a laboratory setting do not ensure any beneficial effect in a real life situation where patients live with individual diet and exercise habits.…”

Section: Introductionmentioning

confidence: 76%

Targeting postprandial hyperglycaemia in patients with recently diagnosed type 2 diabetes with a fixed, weight‐based dose of insulin Aspart

Gredal

Rosenfalck

Dejgaard

et al. 2008

Scandinavian Journal of Clinical and Laboratory Investigation

View full text Add to dashboard Cite

show abstract

“…Compared with the multitude of studies investigating the influence of high‐protein and high‐fat meals, there are fewer studies available regarding the selection of the best time delay between insulin administration and the beginning of carbohydrates‐rich meal consumption. Conclusions are incoherent and do not clearly show the best timing.…”

Section: Discussionmentioning

confidence: 99%

“…Conclusions are incoherent and do not clearly show the best timing. The authors of some studies recommend insulin administration directly before a meal or 15–30 min earlier, which results in decreased excursion rate and longer glucose concentration time lasting within the normal range. In two studies with larger participant groups (76 and 47 participants, respectively), no visible advantage of insulin administration before a meal was found.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has still not been determined what is the best way of using rapid‐acting insulin analogs administration to cover carbohydrates‐rich meals. There are several studies about this topic, but the observations presented are often contradictory and do not lead to clear conclusions. In addition, among the multiple studies assessing glucose profiles, only several fingertip glucose measurements were used.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Assessment of optimal insulin administration timing for standard carbohydrates‐rich meals using continuous glucose monitoring in children with type 1 diabetes: A cross‐over randomized study

Tucholski¹,

Sokołowska

Tucholska³

et al. 2019

J of Diabetes Invest

View full text Add to dashboard Cite

Aims/Introduction The present study was an assessment of postprandial glucose concentration after carbohydrates‐rich meals using continuous glucose monitoring in 30 children with type 1 diabetes treated using continuous subcutaneous insulin infusion with a rapid‐acting insulin analog. Materials and Methods Over a period of 3 days, participants administered simple boluses with different delay times between insulin administration and the beginning of carbohydrates‐rich meal consumption (meal no. 1 containing 197 kcal, no. 2 containing 247 kcal and meal no. 3 containing 323 kcal; containing practically no protein and fat). In the present cross‐over randomized study, we analyzed the average glucose concentration profiles in 5‐min intervals, mean glucose at insulin administration, mean glucose after 120 and 180 min, mean and peak glucose, glucose peak time, areas under the glucose and glucose increase curves, and time period lengths with glucose <50, 70 mg/dL, and >140 and 200 mg/dL. Results For test meals at 20‐min versus 0‐min delay time, the study exposed a longer median time period to reach peak glucose (95 vs 65 min, P = 0.01) after meals. A tendency to the lowest peak and mean glucose, and the longest time with glucose within a normal range was observed in patients who administered bolus insulin 20 min before a meal. Conclusions For carbohydrates‐rich meals, administration of a proper dose of a rapid‐acting insulin analog is crucial. The influence of rapid‐acting insulin analog administration timing seems to be of minor importance in comparison with correct insulin dose adjustment; however, a tendency to achieve more balanced glucose profiles was found in a group who administered insulin 20 min before a meal.

show abstract

Optimal dose and timing of insulin Aspart to mimic first phase insulin response in patients with recently onset type 2 diabetes

Cited by 5 publications

References 29 publications

Optimal prandial timing of bolus insulin in diabetes management: a review

Optimal prandial timing of bolus insulin in diabetes management: a review

Targeting postprandial hyperglycaemia in patients with recently diagnosed type 2 diabetes with a fixed, weight‐based dose of insulin Aspart

Assessment of optimal insulin administration timing for standard carbohydrates‐rich meals using continuous glucose monitoring in children with type 1 diabetes: A cross‐over randomized study

Contact Info

Product

Resources

About