Glucose-lowering effect and glycaemic variability of insulin glargine, insulin detemir and insulin lispro protamine in people with type 1 diabetes

G. Derosa, I. Franzetti, F. Querci, D. Romano, A. D'Angelo, P. Maffioli

Research output: Contribution to journalArticle

Abstract

Aim: To compare, using a continuous glucose monitoring (CGM) system, the effect on glycaemic variability of insulin glargine, detemir and lispro protamine. Methods: A total of 49 white people with type 1 diabetes, not well controlled by three times daily insulin lispro, taken for at least 2months before study and on a stable dose, were enrolled. The study participants were randomized to add insulin glargine, detemir or lispro protamine, once daily, in the evening. We used a CGM system, the iPro Digital Recorder (Medtronic MiniMed, Northridge, CA, USA) for 1week. Glycaemic control was assessed according to mean blood glucose values, the area under the glucose curve above 3.9mmol/l (AUC>3.9) or above 10.0mmol/l (AUC>10.0), and the percentage of time spent with glucose values >3.9 or >10.0mmol/l. Intraday glycaemic variability was assessed using standard deviation (s.d.) values, the mean amplitude of glycaemic excursions and continuous overlapping of net glycaemic action. Day-to-day glycaemic variability was assessed using the mean of daily differences. Results: The s.d. was found to be significantly lower with insulin lispro protamine and glargine compared with insulin detemir. AUC>3.9 was higher and AUC>10.0 was lower with insulin lispro protamine and glargine compared with detemir. The mean amplitude of glycaemic excursions and continuous overlapping net glycaemic action values were lower with insulin lispro protamine and glargine compared with detemir. In addition, the mean of daily differences was significantly lower with insulin lispro protamine and glargine compared with detemir. Fewer hypoglycaemic events were recorded during the night-time with insulin lispro protamine compared with glargine and detemir. Conclusions: The results suggest that insulin lispro protamine and glargine are more effective than detemir in reducing glycaemic variability and improving glycaemic control in people with type 1 diabetes. Insulin lispro protamine seems to lead to fewer hypoglycaemic events than other insulin regimens.

Original languageEnglish
Pages (from-to)554-559
Number of pages6
JournalDiabetes, Obesity and Metabolism
Volume17
Issue number6
DOIs
Publication statusPublished - Jun 1 2015

Keywords

  • Continuous glucose monitoring system
  • Glycaemic variability
  • Insulin detemir
  • Insulin glargine
  • Insulin lispro protamine

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Fingerprint Dive into the research topics of 'Glucose-lowering effect and glycaemic variability of insulin glargine, insulin detemir and insulin lispro protamine in people with type 1 diabetes'. Together they form a unique fingerprint.

  • Cite this