Lispro Is Superior to Regular Insulin in Transient Intensive Insulin Therapy in Type 2 Diabetes

Yuko MURASE, Kunimasa YAGI, Masako SUGIHARA, Daisuke CHUJO, Michio OTSUJI, Hiroaki MURAMOTO, Hiroshi MABUCHI
2004 Internal medicine (Tokyo. 1992)  
Objective The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context. Patients and Methods To explore this possibility, we compared the effect on -and -cell function of transient intensive insulin therapy using lispro versus human regular insulin in a total of 21 type 2 diabetic patients who were randomly assigned to 14-days intensive insulin therapy
more » ... in therapy consisting of bedtime NPH insulin plus three injections of mealtime lispro (n=11) or regular insulin (n=10). The dosages of both types of insulin were adjusted to attain preprandial glucose levels of <6.1 mmol/l within 1 week with similar rates of glucose decline. An oral glucose tolerance test (OGTT) was performed at day 0 (baseline), 7, and 14; plasma glucose, serum insulin, and plasma glucagon responses over 0-120 minutes were measured, and calculated as the area under the curve (AUC). Results Lispro led to a significant reduction in glucose-AUC and also an increase in insulin-AUC versus regular insulin on day 7. Glucagon secretion following OGTT was well suppressed with lispro on day 14 compared to regular insulin. Conclusion Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid -cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits. (Internal Medicine 43: 779-786, 2004)
doi:10.2169/internalmedicine.43.779 pmid:15497510 fatcat:6v3qulpkfrgjdex3grlilxnseq