INSULIN ASPART (NOVOLOG) AND LISPRO (HUMALOG) IN INSULIN PUMPS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Insulin pump therapy is now well established as being part of the management strategy for diabetes-especially type 1. However, despite increased efficacy in clinical trial over multiple daily injections, overall glycemic control in patients on pumps has been disappointing compared to injections, overall glycemic controls in patients on pumps has been disappointing compared to injections. One of the reasons for this is that patients do not adhere to advice about changing their pump needles and lines every 48 hours resulting in 1-2 days of suboptimal control. The recommended duration of "needle use" in pump treatment is 48 hours. This recommendation is based on observation of loss of glycemic control after this time period, which is presumed to be due to line/needle obstruction. However, it is possible that the loss of glycemic control may related to instability of insulin in the pump/line due to the associated temperature change, interaction with line materials, etc. This will be an active control, crossover study to: 1. Compare glycemic control between Humalog and Novolog 24 to 100 hours after a pump infusion line change in patients with diabetes treated with pump using a continous glucose monitoring system (CGMS) and daily measurement of serum Glycomark. 2. Compare the post-prandial glycemic excursion in plasma glucose following a standardized breakfast 48, 72, and 96 hours after a line/infusion change. 3. Store blood for future measurement of possible consequences of loss of control by comparing the post-prandial changes in coagulation, inflammation, protein glycation and oxidative stress following a standardized breakfast 48, 72, and 96 hours after a line/insulin change.