Hiromi Urata1, Katsuhito Mori2, Masanori Emoto1, Yuko Yamazaki1, Koka Motoyama1, Tomoaki Morioka1, Shinya Fukumoto1, Hidenori Koyama3, Tetsuo Shoji4, Eiji Ishimura5, Masaaki Inaba6. 1. Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan. 2. Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan. Electronic address: ktmori@med.osaka-cu.ac.jp. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. 4. Department of Geriatrics and Vascular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan. 5. Department of Nephrology, Graduate School of Medicine, Osaka City University, Osaka, Japan. 6. Department of Metabolism, Endocrinology and Molecular Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Department of Nephrology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
Abstract
OBJECTIVES: To compare the efficacy and safety of insulin glulisine over regular insulin in patients with type 2 diabetes and severe renal insufficiency. SUBJECTS: Our study included 18 patients with type 2 diabetes and a mean (range) estimated glomerular filtration rate of 13.2 mL/minute/1.73 m(2) (5.8-27.6), which corresponds to stage 4-5 chronic kidney disease. DESIGN: After titration of doses, regular insulin was administered thrice daily on Day 1, along with continuous glucose monitoring for 24 h starting at 7 am. Exactly equal doses of insulin glulisine were administered on Day 2. Area under the curve (AUC) for blood glucose level variation after breakfast (AUC-B 0-4), lunch (AUC-L 0-6), and dinner (AUC-D 0-6) were evaluated. RESULTS: AUC-B 0-4 and AUC-D 0-6 were significantly lower with insulin glulisine than with regular insulin (AUC-B 0-4: 3.3 ± 4.7 vs. 6.2 ± 5.4 × 10(2) mmol/L·minute, respectively, P = .028; AUC-D 0-6: 1.8 ± 7.3 vs. 6.5 ± 6.2 × 10(2) mmol/L·minute, respectively, P = .023). In contrast, AUC-L 0-6 was higher with insulin glulisine than with regular insulin (AUC-L 0-6: 7.6 ± 6.4 vs. 4.2 ± 8.7 × 10(2) mmol/L·minute, respectively, P = .099), suggesting a prolonged hypoglycemic action of regular insulin after lunch. CONCLUSIONS: Insulin glulisine effectively suppressed postprandial hyperglycemia, whereas regular insulin caused a prolonged hypoglycemic action. These findings support the effectiveness and safety of insulin glulisine in patients with type 2 diabetes and severe renal insufficiency.
OBJECTIVES: To compare the efficacy and safety of insulinglulisine over regular insulin in patients with type 2 diabetes and severe renal insufficiency. SUBJECTS: Our study included 18 patients with type 2 diabetes and a mean (range) estimated glomerular filtration rate of 13.2 mL/minute/1.73 m(2) (5.8-27.6), which corresponds to stage 4-5 chronic kidney disease. DESIGN: After titration of doses, regular insulin was administered thrice daily on Day 1, along with continuous glucose monitoring for 24 h starting at 7 am. Exactly equal doses of insulinglulisine were administered on Day 2. Area under the curve (AUC) for blood glucose level variation after breakfast (AUC-B 0-4), lunch (AUC-L 0-6), and dinner (AUC-D 0-6) were evaluated. RESULTS: AUC-B 0-4 and AUC-D 0-6 were significantly lower with insulinglulisine than with regular insulin (AUC-B 0-4: 3.3 ± 4.7 vs. 6.2 ± 5.4 × 10(2) mmol/L·minute, respectively, P = .028; AUC-D 0-6: 1.8 ± 7.3 vs. 6.5 ± 6.2 × 10(2) mmol/L·minute, respectively, P = .023). In contrast, AUC-L 0-6 was higher with insulinglulisine than with regular insulin (AUC-L 0-6: 7.6 ± 6.4 vs. 4.2 ± 8.7 × 10(2) mmol/L·minute, respectively, P = .099), suggesting a prolonged hypoglycemic action of regular insulin after lunch. CONCLUSIONS:Insulinglulisine effectively suppressed postprandial hyperglycemia, whereas regular insulin caused a prolonged hypoglycemic action. These findings support the effectiveness and safety of insulinglulisine in patients with type 2 diabetes and severe renal insufficiency.
Authors: K Mori; M Emoto; R Numaguchi; Y Yamazaki; H Urata; K Motoyama; T Morioka; T Shoji; M Inaba Journal: Acta Endocrinol (Buchar) Date: 2017 Apr-Jun Impact factor: 0.877
Authors: Carolina C R Betônico; Silvia M O Titan; Maria Lúcia C Correa-Giannella; Márcia Nery; Márcia Queiroz Journal: Clinics (Sao Paulo) Date: 2016-01 Impact factor: 2.365