Comparison of Insulin Aspart and Lispro: Pharmacokinetic and metabolic effects
OBJECTIVE -To compare insulin levels and actions in patients with type 1 diabetes after subcutaneous injection of the rapid-acting insulin analogs aspart and lispro. RESEARCH DESIGN AND METHODS -Seven C-peptide-negative patients with type 1 diabetes (two men and five women) were studied at the General Clinical Research Center at Temple University Hospital two times, 1 month apart. Their plasma glucose was normalized overnight by intravenous infusion of insulin. The next morning, they received
... ng, they received subcutaneous injections of either aspart or lispro (9.4 Ϯ 1.9 U) in random order. For the next 4 -5 h, their plasma glucose was clamped at ϳ5.5 mmol/l with a variable infusion of 20% glucose. The study was terminated after 8 h. RESULTS -Both insulin analogs produced similar serum insulin levels (250 -300 pmol/l) at ϳ30 min and disappeared from serum after ϳ4 h. Insulin aspart and lispro had similar effects on glucose and fat metabolism. Effects on carbohydrate metabolism (glucose uptake, glucose oxidation, and endogenous glucose production) peaked after ϳ2-3 h and disappeared after ϳ5-6 h. Effects on lipid metabolism (plasma free fatty acid, ketone body levels, and free fatty acid oxidation) appeared to peak earlier (at ϳ2 h) and disappeared earlier (after ϳ4 h) than the effects on carbohydrate metabolism. CONCLUSIONS -We conclude that both insulin aspart and lispro are indistinguishable from each other with respect to blood levels and that they are equally effective in correcting abnormalities in carbohydrate and fat metabolism in patients with type 1 diabetes.