[Efficacy of insulin Lispro in the control of late postprandial hypoglycemia: comparison with regular human insulin].

BACKGROUND: Lispro insulin a recently developed analogue of human insulin, is more rapidly adsorbed and has a lower duration of activity as compared with regular insulin. This implies a glycemic profile closer to the physiologic one with a reduction of early post-prandial hyperglycemic peak and of drop in late postprandial glycemia. This results in a reduction of mild or severe hypoglycemia occurring during treatment with regular human insulin. METHODS: This was designed to evaluate the efficacy of Lispro insulin in the metabolic control in subjects treated with regular insulin who were prone to late hypoglycemia. Fifteen subjects, 6 males and 9 females, range of age 18-54 years with insulin-dependent diabetes mellitus (IDDM) have been studied. These subjects were treated with regular insulin at meals plus intermediate in the evening. Regular insulin was substituted with Lispro insulin. The glycemic profile and HbA1c have been evaluated at determined intervals. Also body mass index and the number of hypoglycemic events during treatment were recorded. Significance of differences was assessed by paired Student's "t"-test. RESULTS: Lispro insulin reduced the peaks of early postprandial hyperglycemic peak and, in particular, the late glycemic drop, Lispro insulin reduced also HbA1c levels thus suggesting a better metabolic control. Moreover the number of hypoglycemic events was significantly reduced. CONCLUSIONS: In conclusion, Lispro insulin is safe and more efficient than regular human insulin.