Document Detail


Comparison of pharmacodynamic intrasubject variability of insulin lispro protamine suspension and insulin glargine in subjects with type 1 diabetes.
MedLine Citation:
PMID:  20508081     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to evaluate pharmacodynamic (PD) intrasubject variability of a single, s.c. dose of insulin lispro protamine suspension (ILPS) compared with insulin glargine in subjects with type 1 diabetes mellitus and additionally, to compare the intrasubject variability of pharmacokinetic parameters of both insulins. DESIGN: This was a single-center, investigator-blinded and subject-blinded, two-arm, parallel, randomized, four-period study. During the replicate visits, subjects received a single s.c. 0.6 U/kg dose of either ILPS or glargine, and underwent 24-h euglycemic glucose clamps. RESULTS: The intrasubject variabilities of the primary PD parameters, total amount of glucose infused (G(tot)) and maximum glucose infusion rate (GIR; R(max)), were statistically significantly lower for ILPS when compared with glargine (P<0.0001). Least-square (LS) mean estimates for G(tot) and R(max) were 2512.7 mg/kg and 3.740 mg/min per kg respectively for ILPS, and 1291.9 mg/kg and 1.793 mg/min per kg respectively for glargine. The LS mean estimates for G(tot) and R(max) were statistically greater (P=0.0010 and P<0.0001 respectively) for ILPS compared with glargine, suggesting that ILPS had greater 24-h glucose-lowering activity. Glargine demonstrated a flatter GIR-time curve, and ILPS demonstrated a significantly shorter time of maximum GIR (tR(max)) and earlier time to half-maximal GIR before tR(max) and time to half-maximal GIR after tR(max). ILPS administration resulted in significantly greater exposure compared with glargine (area under the baseline-corrected serum concentration versus time curve from time 0 to 24 h (AUC(0-24)): 77 150 vs 53 111 pmol min/l; maximum serum insulin concentration (C(max)): 119 vs 68 pmol/l; ILPS versus glargine respectively), but the intrasubject variabilities for AUC and C(max) were comparable. CONCLUSION: Although glargine demonstrated a flatter GIR-time profile, the lower PD intrasubject variability of ILPS may provide a more predictable response.
Authors:
S M Ocheltree; M Hompesch; E T Wondmagegnehu; L Morrow; K Win; S J Jacober
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-05-27
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  163     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  217-23     Citation Subset:  IM    
Affiliation:
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana 46285, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Area Under Curve
Blood Glucose
Body Mass Index
Diabetes Mellitus, Type 1 / blood,  drug therapy*
Double-Blind Method
Female
Glucose Clamp Technique
Humans
Hypoglycemic Agents / pharmacology,  therapeutic use
Individuality
Insulin / analogs & derivatives*,  blood,  pharmacology,  therapeutic use
Male
Middle Aged
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hypoglycemic Agents; 0/glargine; 11061-68-0/Insulin; 133107-64-9/insulin LISPRO

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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