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Effects of mealtime insulin aspart and bedtime NPH insulin on postprandial coagulation and fibrinolysis in patients with type 2 diabetes.
MedLine Citation:
PMID:  22151836     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims: Acute hyperglycaemia induces coagulation activation in diabetes patients. We hypothesized that rapid-acting insulin has a beneficial postprandial effect on coagulation and fibrinolysis compared with intermediate-acting insulin due to its ability to lower postprandial hyperglycaemia. Materials and Methods: This was tested in a parallel controlled study in well-controlled patients with type 2 diabetes assigned to bedtime NPH insulin (n=41) or mealtime insulin aspart (n=37). They were served standard diabetic meals for breakfast (8:00) and lunch (12:00). Blood samples were collected at 7:40 (fasting), 9:30, 11:30, 13:30, and 15:30 and analysed for glucose, activated factor VII (FVIIa), D-dimer, prothrombin fragment 1+2 (F1+2), tissue plasminogen activator antigen (t-PA), and plasminogen activator inhibitor activity (PAI). Results: The postprandial glucose response differed significantly between insulin regimens with a postprandial increase on NPH insulin and a decrease on insulin aspart. There was a significant postprandial decrease in F1+2, PAI, and t-PA, and no changes in FVIIa and D-dimer, on both insulin regimens, but with no differences between insulin treatment groups. Conclusions: The rapid-acting insulin analogue aspart and the intermediate-acting insulin NPH had similar postprandial effects on markers of coagulation activation and fibrinolysis despite different effects on postprandial glucose response.
Authors:
Em Bladbjerg; Je Henriksen; S Akram; J Gram
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-8
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  -     ISSN:  1463-1326     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Unit for Thrombosis Research, Institute of Public Health, the University of Southern Denmark and Department of Clinical Biochemistry, Hospital of South West Denmark, Esbjerg, Denmark Department of Endocrinology, Odense University Hospital, Odense, Denmark Department of Endocrinology, Hospital of South West Denmark, Esbjerg, Denmark.
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