Improved Glycemic Control With Insulin Aspart: A multicenter randomized double-blind crossover trial in type 1 diabetic patients


    loading  Checking for direct PDF access through Ovid

Abstract

OBJECTIVETo compare glycemic control obtained with the new rapid-acting insulin analog insulin apart with that obtained with unmodified human insulin using algorithm-driven dosage adjustment.RESEARCH DESIGN AND METHODSThis was a multicenter randomized double-blind crossover study of 90 male subjects with type 1 diabetes. Insulin aspart or soluble human insulin was administered before meals, and NPH insulin was administered at bedtime as basal therapy. Each 4-week study period ended with a 24-h inpatient serum insulin and plasma glucose profile.RESULTSThe 24-h plasma glucose control obtained with insulin aspart, as assessed by excursions of blood glucose outside a predefined normal range (4.0-7.0 mmol/l), was superior (22% reduction in excursion, P < 0.01). Fructosamine levels remained unchanged with insulin aspart, with daytime glycemic control superior but nighttime glycemic control inferior. Eight-point home blood glucose profiles confirmed that insulin aspart significantly improved postprandial blood glucose control after lunch and dinner (P < 0.05) without deterioration of preprandial blood glucose control. Hypoglycemic episodes requiring third-party intervention were significantly fewer with insulin aspart than with human insulin (20 vs. 44 events, P < 0.002). Insulin aspart was well tolerated.CONCLUSIONSIn comparison with human insulin, insulin aspart can improve postprandial glycemic control as assessed by a reduction in hyper- and hypoglycemic excursions in people with type 1 diabetes. For its full potential to be realized, it will need to provide better control of nighttime hyperglycemia. Diabetes Care 21:1904-1909, 1998

    loading  Loading Related Articles