OBJECTIVE: To compare glycemic control obtained with the new rapid-acting insulin analog insulin aspart with that obtained with unmodified human insulin using algorithm-driven dosage adjustment. RESEARCH DESIGN AND METHODS: This 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. RESULTS: The 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 mmo/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. CONCLUSIONS: In 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.
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Abstract|
November 01 1998
Improved glycemic control with insulin aspart: a multicenter randomized double-blind crossover trial in type 1 diabetic patients. UK Insulin Aspart Study Group.
P D Home;
P D Home
Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne, UK. [email protected]
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A Lindholm;
A Lindholm
Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne, UK. [email protected]
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B Hylleberg;
B Hylleberg
Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne, UK. [email protected]
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P Round
P Round
Human Diabetes and Metabolism Research Centre, University of Newcastle upon Tyne, UK. [email protected]
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Citation
P D Home, A Lindholm, B Hylleberg, P Round; Improved glycemic control with insulin aspart: a multicenter randomized double-blind crossover trial in type 1 diabetic patients. UK Insulin Aspart Study Group.. Diabetes Care 1 November 1998; 21 (11): 1904–1909. https://doi.org/10.2337/diacare.21.11.1904
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