Counter-regulatory hormone responses to spontaneous hypoglycaemia during treatment with insulin Aspart or human soluble insulin: a double-blinded randomized cross-over study
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Counter-regulatory hormone responses to spontaneous hypoglycaemia during treatment with insulin Aspart or human soluble insulin : a double-blinded randomized cross-over study. / Brock Jacobsen, I; Vind, B F; Korsholm, Lars; Flyvbjerg, A; Frystyk, Jan; Holst, Jens Juul; Beck-Nielsen, Henning; Henriksen, J E.
In: Acta Physiologica (Print), Vol. 202, No. 3, 2011, p. 337-347.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Counter-regulatory hormone responses to spontaneous hypoglycaemia during treatment with insulin Aspart or human soluble insulin
T2 - a double-blinded randomized cross-over study
AU - Brock Jacobsen, I
AU - Vind, B F
AU - Korsholm, Lars
AU - Flyvbjerg, A
AU - Frystyk, Jan
AU - Holst, Jens Juul
AU - Beck-Nielsen, Henning
AU - Henriksen, J E
N1 - © 2011 The Authors. Acta Physiologica © 2011 Scandinavian Physiological Society.
PY - 2011
Y1 - 2011
N2 - To compare insulin Aspart and human insulin with respect to glycaemic control, hypoglycaemic frequency and counter-regulatory responses to spontaneous hypoglycaemia. Methods: Glycaemic control, hypoglycaemic frequency, p-insulin concentrations, insulin dosages and patients’ satisfaction were examined in a randomized, double-blinded cross-over study for two periods of 8 weeks. Sixteen patients with type 1 diabetes were subjected to three daily injections of human soluble insulin or Aspart in addition to Neutral Protamine Hagedorn (NPH) insulin twice daily. Each intervention period was followed by hospitalization where episodes of spontaneous hypoglycaemia and counter-regulatory hormone responses were evaluated from frequently obtained blood samples. Results: No difference between soluble insulin and insulin Aspart was found regarding HbA1c (7.0 0.2 vs. 7.0 0.2%, ns), hypoglycaemic frequency (1.1 0.2 vs. 0.9 0.1 events per patient per week, ns), nocturnal hypoglycaemia, severe hypoglycaemic events, dosages of bolus insulin (31.8 0.4 vs. 30.0 0.6 IU day)1, ns), or NPH insulin (26.7 1.8 vs. 26.0 1.7 IU day)1, ns) or in patients satisfaction (ns). Modest differences existed in the counter-regulatory responses regarding growth hormone, glucagon and ghrelin whereas no differences were found in relation to free fatty acid, cortisol, insulin-like growth factor (IGF)-I, IGF-II and IGF-binding proteins 1 and 2. Treatment with insulin Aspart resulted in well-defined peaks in serum insulin concentrations as compared with more blunted insulin peaks using human soluble insulin. Conclusion: Although insulin Aspart treatment was associated with clear postprandial insulin peaks, no improvement in glycaemic control was obtained and no difference in the hypoglycaemic frequency was observed. However, insulin Aspart elicited a slightly different physiological response to spontaneous hypoglycaemia compared with human insulin. Keywords hypoglycaemia counter-regulation, insulin Aspart, type 1 diabetes.
AB - To compare insulin Aspart and human insulin with respect to glycaemic control, hypoglycaemic frequency and counter-regulatory responses to spontaneous hypoglycaemia. Methods: Glycaemic control, hypoglycaemic frequency, p-insulin concentrations, insulin dosages and patients’ satisfaction were examined in a randomized, double-blinded cross-over study for two periods of 8 weeks. Sixteen patients with type 1 diabetes were subjected to three daily injections of human soluble insulin or Aspart in addition to Neutral Protamine Hagedorn (NPH) insulin twice daily. Each intervention period was followed by hospitalization where episodes of spontaneous hypoglycaemia and counter-regulatory hormone responses were evaluated from frequently obtained blood samples. Results: No difference between soluble insulin and insulin Aspart was found regarding HbA1c (7.0 0.2 vs. 7.0 0.2%, ns), hypoglycaemic frequency (1.1 0.2 vs. 0.9 0.1 events per patient per week, ns), nocturnal hypoglycaemia, severe hypoglycaemic events, dosages of bolus insulin (31.8 0.4 vs. 30.0 0.6 IU day)1, ns), or NPH insulin (26.7 1.8 vs. 26.0 1.7 IU day)1, ns) or in patients satisfaction (ns). Modest differences existed in the counter-regulatory responses regarding growth hormone, glucagon and ghrelin whereas no differences were found in relation to free fatty acid, cortisol, insulin-like growth factor (IGF)-I, IGF-II and IGF-binding proteins 1 and 2. Treatment with insulin Aspart resulted in well-defined peaks in serum insulin concentrations as compared with more blunted insulin peaks using human soluble insulin. Conclusion: Although insulin Aspart treatment was associated with clear postprandial insulin peaks, no improvement in glycaemic control was obtained and no difference in the hypoglycaemic frequency was observed. However, insulin Aspart elicited a slightly different physiological response to spontaneous hypoglycaemia compared with human insulin. Keywords hypoglycaemia counter-regulation, insulin Aspart, type 1 diabetes.
KW - Adolescent
KW - Adult
KW - Blood Glucose
KW - Cross-Over Studies
KW - Diabetes Mellitus, Type 1
KW - Double-Blind Method
KW - Fatty Acids, Nonesterified
KW - Female
KW - Ghrelin
KW - Glucagon
KW - Hormones
KW - Human Growth Hormone
KW - Humans
KW - Hydrocortisone
KW - Hypoglycemia
KW - Hypoglycemic Agents
KW - Insulin
KW - Insulin Aspart
KW - Insulin, Isophane
KW - Male
KW - Middle Aged
KW - Young Adult
U2 - 10.1111/j.1748-1716.2011.02307.x
DO - 10.1111/j.1748-1716.2011.02307.x
M3 - Journal article
C2 - 21481195
VL - 202
SP - 337
EP - 347
JO - Acta Physiologica
JF - Acta Physiologica
SN - 1748-1708
IS - 3
ER -
ID: 40321129