Prandial Glycaemia After a Carbohydrate‐rich Meal in Type I Diabetic Patients: Using the Rapid Acting Insulin Analogue [Lys(B28), Pro(B29)] Human Insulin

Heinemann, L; Heise, Tim; Wahl, L.Ch.; Trautmann, Michael E.; Ampudia, Jeanette; Starke, A.; Berger, Michael

doi:10.1002/(sici)1096-9136(199607)13:7<625::aid-dia134>3.3.co;2-u

Cited by 53 publications

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“…Several studies involving rapid-acting insulin analogs such as insulin aspart and insulin lispro have consistently demonstrated that a rapid onset of action leads to improvements in postprandial blood glucose control (6,11,12). However, clinical studies have shown that the duration of action of rapid-acting insulin analogs may be too short to provide adequate postprandial control, as indicated by rising glucose levels in the postabsorptive state (13,14).…”

Section: Pharmacokinetic Resultsmentioning

confidence: 99%

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Time-Action Profile of Inhaled Insulin in Comparison With Subcutaneously Injected Insulin Lispro and Regular Human Insulin

et al. 2005

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OBJECTIVE -This study compares the time-action profile of inhaled insulin (INH; Exubera) with that of subcutaneously injected insulin lispro (ILP) or regular human insulin (RHI) in healthy volunteers. RESEARCH DESIGN AND METHODS-In this open-label, randomized, three-way, crossover study, 17 healthy male volunteers were given each of the following treatments in random order: INH (6 mg), ILP (18 units), or RHI (18 units). Glucose infusion rates and serum insulin concentrations were monitored over 10 h. CONCLUSIONS -INH had a faster onset of action than RHI or ILP and a duration of action longer than ILP and comparable to RHI. These characteristics suggest that inhaled insulin is suitable for prandial insulin supplementation in patients with diabetes. RESULTS Diabetes Care 28:1077-1082, 2005T he pulmonary delivery of insulin is currently being studied as an alternative method of insulin administration. Early studies have shown promising results, and it has been demonstrated that the onset of action of inhaled insulin is faster than that of regular human insulin (RHI), resembling that of rapid-acting insulin analogs (1-5). RHI has several disadvantages when its use for controlling prandial glycemia is considered. A relatively slow onset of action and a prolonged duration of action results in a suboptimal time-action profile (6). In addition, subcutaneous insulin injections are often considered inconvenient and cause anxiety for many patients (7).Inhaled insulin may be a viable alternative to prandial insulin administration for patients with diabetes because of its more favorable pharmacokinetic profile and less invasive route of administration. However, a direct comparison of the pharmacodynamic properties of INH and subcutaneously injected rapid-acting insulin analogs has not yet been performed. The purpose of this study was to compare the pharmacokinetic and pharmacodynamic properties of human insulin administered to the lung using a novel drypowder inhaled insulin delivery system with those of subcutaneously injected RHI and the rapid-acting insulin analog insulin lispro (ILP). RESEARCH DESIGN ANDMETHODS -Eighteen healthy, nonsmoking male volunteers (age 28 Ϯ 4 years, BMI 23.6 Ϯ 2.0 kg/m 2 ) participated in this open-label, randomized, three-way, crossover study. Seventeen participants completed the study; one withdrew after receiving his first study treatment (INH) due to an adverse event (sepsis) attributed to the testing procedure and not the study treatment.Subjects gave written informed consent and underwent a physical examinat i o n , 1 2 -l e a d e l e c t r o c a r d i o g r a m recording, and clinical laboratory tests. All subjects had normal lung function (mean forced expiratory volume in 1 s [FEV 1 ] Ͼ80% of predicted normal value; FEV 1 -to-forced vital capacity ratio Ͼ0.80) as measured in a standing position using a Spirovit Baar, Switzerland). Nonsmoking status was verified using a negative urine cotinine excretion test (LCMS method, API 3ϩ; Perkin-Elmer, Weiterstadt, Ger-

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Section: Pharmacokinetic Resultsmentioning

confidence: 99%

“…RHI has several disadvantages when its use for controlling prandial glycemia is considered. A relatively slow onset of action and a prolonged duration of action results in a suboptimal time-action profile (6). In addition, subcutaneous insulin injections are often considered inconvenient and cause anxiety for many patients (7).…”

mentioning

confidence: 99%

Time-Action Profile of Inhaled Insulin in Comparison With Subcutaneously Injected Insulin Lispro and Regular Human Insulin

et al. 2005

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“…The better postprandial glycaemic control after a carbohydrate-rich meal with lispro compared with regular human insulin [85], as well as the more convenient mealtime or postprandial injection, make use of lispro attractive in children [86,87]. Type I diabetic children, however, lose residual endogenous insulin secretion faster than adult patients [88].…”

Section: Reviewmentioning

confidence: 93%

Insulin analogues and their potential in the management of diabetes mellitus

Bolli

Marchi

Park³

et al. 1999

Diabetologia

322

211

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“…Injection of these rapidly acting analogues results in twice the maximal concentration, in half the time (30-90 minutes) equivalent doses of soluble (regular) insulin (2-3 hours) [3,4,5,6,7]. This results in better control of postprandial blood-glucose concentration and less frequent occurrence of post prandial hypoglycaemia compared to soluble insulin.…”

Section: Rapid Acting Recombinant Human Insulin Analogues Eg Insulimentioning

confidence: 99%

Update on newer antidiabetic drugs in clinical practice

Wanigatunge

2018

J. Postgrad. Inst. Med.

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Prandial Glycaemia After a Carbohydrate‐rich Meal in Type I Diabetic Patients: Using the Rapid Acting Insulin Analogue [Lys(B28), Pro(B29)] Human Insulin

Cited by 53 publications

References 0 publications

Time-Action Profile of Inhaled Insulin in Comparison With Subcutaneously Injected Insulin Lispro and Regular Human Insulin

Time-Action Profile of Inhaled Insulin in Comparison With Subcutaneously Injected Insulin Lispro and Regular Human Insulin

Insulin analogues and their potential in the management of diabetes mellitus

Update on newer antidiabetic drugs in clinical practice

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