المؤلفون: Porcellati F, Lucidi P, Rossetti P, Candeloro P, Marinelli Andreoli A, Marzotti S, Cioli P, Bolli GB, Fanelli CG, Porcellati, Francesca, Lucidi, Paola, Rossetti, Paolo, Candeloro, Paola, Andreoli, Anna Marinelli, Marzotti, Stefania, Cioli, Patrizia, Bolli, Geremia B, Fanelli, Carmine G

المصدر: Diabetes Care; Dec2011, Vol. 34 Issue 12, p2521-2523, 3p

مستخلص: Objective: To assess the role of adiposity on the pharmacodynamics of basal insulins NPH, detemir, and glargine in type 2 diabetes mellitus (T2DM), as estimated by glucose infusion rate (GIR) and endogenous glucose production (EGP) rate in the euglycemic clamp.Research Design and Methods: We examined the variables that best predicted GIR and EGP in 32-h clamp studies after treatment with subcutaneous injection of 0.4 units/kg NPH, detemir, and glargine in 18 T2DM subjects (crossover).Results: A multiple regression analysis revealed that BMI best predicted GIR variation during the clamp. BMI was inversely correlated with GIR in all three insulin treatments, but was statistically significant in detemir treatment only. BMI correlated positively with residual suppression of EGP in detemir, but not with glargine and NPH treatments.Conclusions: Adiposity blunts the pharmacodynamics of all basal insulins in T2DM. However, as adiposity increases, the effect of detemir is lower versus NPH and glargine. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetes Care is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Lucidi P, Porcellati F, Rossetti P, Candeloro P, Cioli P, Marzotti S, Andreoli AM, Fede R, Bolli GB, Fanelli CG, Lucidi, Paola, Porcellati, Francesca, Rossetti, Paolo, Candeloro, Paola, Cioli, Patrizia, Marzotti, Stefania, Andreoli, Anna Marinelli, Fede, Raffaela, Bolli, Geremia B, Fanelli, Carmine G

المصدر: Diabetes Care; Jun2011, Vol. 34 Issue 6, p1312-1314, 3p

مصطلحات موضوعية: INSULIN pharmacokinetics, BLOOD sugar, CIRCADIAN rhythms, CROSSOVER trials, DRUG administration, INSULIN, TYPE 2 diabetes, RANDOMIZED controlled trials, BLIND experiment

مستخلص: Objective: To compare the pharmacokinetics and pharmacodynamics of NPH, glargine, and detemir insulins in type 2 diabetic subjects.Research Design and Methods: This study used a single-blind, three-way, cross-over design. A total of 18 type 2 diabetic subjects underwent a euglycemic clamp for 32 h after a subcutaneous injection of 0.4 units/kg at 2200 h of either NPH, glargine, or detemir after 1 week of bedtime treatment with each insulin.Results: The glucose infusion rate area under the curve(0-32 h) was greater for glargine than for detemir and NPH (1,538 ± 688; 1,081 ± 785; and 1,170 ± 703 mg/kg, respectively; P < 0.05). Glargine suppressed endogenous glucose production more than detemir (P < 0.05) and similarly to NPH (P = 0.16). Glucagon, C-peptide, free fatty acids, and β-hydroxy-butyrate were more suppressed with glargine than detemir. All 18 subjects completed the glargine study, but two subjects on NPH and three on detemir interrupted the study because of plasma glucose >150 mg/dL.Conclusions: Compared with NPH and detemir, glargine provided greater metabolic activity and superior glucose control for up to 32 h. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetes Care is the property of American Diabetes Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)