Mealtime treatment with insulin analog improves postprandial hyperglycemia and hypoglycemia in patients with non-insulin-dependent diabetes mellitus
Mealtime treatment with insulin analog improves postprandial hyperglycemia and hypoglycemia in patients with non-insulin-dependent diabetes mellitus
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DOI：
10.1001/archinte.157.11.1249
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发表时间：
1997-06-09
影响因子：
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通讯作者：
DiMarchi, R
中科院分区：
文献类型：
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作者：
Anderson, JH;Brunelle, RL;DiMarchi, R
背景：赖脯胰岛素是最近开发的一种胰岛素类似物，专门用于餐时治疗。它具有吸收速度快，作用时间短的特点。赖脯胰岛素在非胰岛素依赖型糖尿病（NIDDM）患者的临床治疗中的有效性尚未得到验证。目的：比较赖脯胰岛素和常规人胰岛素在NIDDM患者餐时治疗中的效果。一项为期6个月、随机、多国研究在722例NIDDM患者中进行了一项开放标签、交叉设计的多中心（80个中心）临床试验。赖脯胰岛素注射前立即和人常规胰岛素30至45 minutes before the meal.Results：在整个研究中，餐后血糖水平的上升明显低于赖脯胰岛素治疗期间比人常规胰岛素。在终点，1小时时血清葡萄糖水平（平均SEM）降低30%（赖脯胰岛素为2.6+/-0.1 mmol/L [46.8+/-1.8 mg/ dL]，人常规胰岛素为3.7+/-0.1 mmol/L [66.6+/-1.8 mg/dL]），试验餐后2小时降低53%（赖脯胰岛素为1.4+/-0.1 mmol/L [25.2+/-1.8 mg/dL] vs人常规胰岛素为3.0+/-0.1 mmol/L [54.0+/-1.8 mg/dL]）与人常规胰岛素治疗相比（P
Background: Insulin lispro is an insulin analog that was recently developed particularly for a mealtime therapy. It has a fast absorption rate and short duration of action. The efficacy of insulin lispro in the clinical therapy of patients with non-insulin-dependent diabetes mellitus (NIDDM) has not been tested.Objectives: To compare insulin lispro and human regular insulin in the mealtime treatment of patients with NIDDM.Methods: A 6-month, randomized, multinational (16 countries), multicenter (80 sites) clinical trial with an open-label, crossover design was performed in 722 patients with NIDDM. Insulin lispro was injected immediately before and human regular insulin 30 to 45 minutes before the meal.Results: Throughout the study, the postprandial rise in serum glucose levels was significantly lower during insulin lispro than human regular insulin treatment. At end point the rise (mean SEM) in serum glucose levels was 30% lower at 1 hour (2.6+/-0.1 mmol/L [46.8+/-1.8 mg/ dL] for lispro vs 3.7+/-0.1 mmol/L [66.6+/-1.8 mg/dL] for human regular insulin) and 53% lower 2 hours after the test meal (1.4+/-0.1 mmol/L [25.2+/-1.8 mg/dL] for lispro vs 3.0+/-0.1 mmol/L [54.0+/-1.8 mg/dL] for human regular insulin) with insulin lispro compared with human regular insulin therapy (P