Effects of the Short-Acting Insulin Analog [Lys(B28),Pro(B29)] on Postprandial Blood Glucose Control in IDDM

OBJECTIVE To establish the effects of the short-acting insulin analog Lispro versus human regular insulin (Hum-R) on postprandial metabolic control in IDDM. RESEARCH DESIGN AND METHODS Four studies were performed in 10 C-peptide-negative IDDM patients. Lispro or Hum-R (0.15 U/kg) or Lispro + NPH (0.07 U/kg) or Hum-R + NPH were injected subcutaneously 30 min (Hum-R) or 5 min (Lispro) before lunch. Preprandial plasma glucose (PG) was maintained on all four occasions at ∼ 7.3 mmol/l by intravenous insulin. RESULTS After subcutaneous Lispro injection, plasma free insulin (FIRI) was greater between 0 and 2 h (233 ± 22 pmol/l) than after Hum-R (197 ± 25 pmol/l) but lower between 2.25 and 7 h (81 ± 10 vs. 104 ± 13 pmol/l, P P P CONCLUSIONS At meals, in order for Lispro to improve postprandial blood glucose not only at 2-h, but also over a 7-h period in C-peptide–negative IDDM, basal insulin must be optimally replaced.