Lispro is superior to regular insulin in transient intensive insulin therapy in type 2 diabetes

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概要

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• Objective. The optimal approach to relatively recent onset type 2 diabetes patients is still unknown. We speculated that the use of short-acting insulin analogs might be of particular benefit in this context. Patients and Methods. To explore this possibility, we compared the effect on β- and α-cell function of transient intensive insulin therapy using lispro versus human regular insulin in a total of 21 type 2 diabetic patients who were randomly assigned to 14-days intensive insulin therapy consisting of bedtime NPH insulin plus three injections of mealtime lispro (n=11) or regular insulin (n=10). The dosages of both types of insulin were adjusted to attain preprandial glucose levels of <6.1 mmol/l within 1 week with similar rates of glucose decline. An oral glucose tolerance test (OGTT) was performed at day 0 (baseline), 7, and 14; plasma glucose, serum insulin, and plasma glucagon responses over 0-120 minutes were measured, and calculated as the area under the curve (AUC). Results. Lispro led to a significant reduction in glucose-AUC and also an increase in insulin-AUC versus regular insulin on day 7. Glucagon secretion following OGTT was well suppressed with lispro on day 14 compared to regular insulin. Conclusion. Two-week intensive insulin therapy with lispro appeared to be more effective than that with regular insulin in type 2 diabetes in attaining both more rapid β-cell rest and greater suppression of glucagon. These changes may provide significant long-term benefits.

• 日本内科学会の論文
• 2004-09-01

著者

• Mabuchi Hiroshi

  Molecular Genetics of Cardiovascular Disorders, Division of Cardiovascular Medicine, Graduate School

• Mabuchi Hiroshi

  Departments Of Lipidology Kanazawa University Graduate School Of Medical Science

• Yagi Kunimasa

  Department of Internal Medicine, Kanazawa University Graduate School of Medical Science

• Yagi Kunimasa

  金沢大学 医学系研究科循環医科学専攻臓器機能制御学

• Yagi Kunimasa

  Department Of Internal Medicine Kanazawa University Graduate School Of Medical Science

• Yagi Kunimasa

  Department Of Internal Medicine Kanazawa University Hospital

• MURAMOTO Hiroaki

  Kanazawa Social Insurance Hospital

• MURASE Yuko

  Department of Lifestyle-related disease, Kanazawa University Graduate School of Medical Science

• Murase Yuko

  Department Of Lifestyle-related Disease Kanazawa University Graduate School Of Medical Science

• Murase Yuko

  Molecular Genetics Of Cardiovascular Disorders Graduate School Of Medical Science Kanazawa Universit

• YAGI Kunimasa

  Molecular Genetics of Cardiovascular Disorders, Graduate School of Medical Science, Kanazawa Univers

• SUGIHARA Masako

  Department of Internal Medicine, Kanazawa Social Insurance Hospital

• CHUJO Daisuke

  Molecular Genetics of Cardiovascular Disorders, Graduate School of Medical Science, Kanazawa Univers

• OTSUJI Michio

  Molecular Genetics of Cardiovascular Disorders, Graduate School of Medical Science, Kanazawa Univers

• MURAMOTO Hiroaki

  Department of Internal Medicine, Kanazawa Social Insurance Hospital

• Otsuji Michio

  Molecular Genetics Of Cardiovascular Disorders Graduate School Of Medical Science Kanazawa Universit

• Chujo Daisuke

  Department Of Internal Medicine Kanazawa University Hospital

• Yagi Kunimasa

  Division Of Cardiovascular Medicine Kanazawa University Graduate School Of Medicine

• Yagi Kunimasa

  Molecular Genetics Of Cardiovascular Disorders Graduate School Of Medical Science Kanazawa Universit

• Mabuchi Hiroshi

  Molecular Genetics Of Cardiovascular Disorders Graduate School Of Medical Science Kanazawa Universit

• Mabuchi Hiroshi

  Molecular Genetics Of Cardiovascular Disorders Vascular Medicine Division Of Cardiovascular Medicine

• Sugihara Masako

  Department Of Internal Medicine Kanazawa Social Insurance Hospital

• Mabuchi Hiroshi

  Molecular Genetics Of Cardiovascular Disorders Division Of Cardiovascular Medicine Graduate School O

• Otsuji Michiko

  Molecular Genetics of Cardiovascular Disorders, Graduate School of Medical Science, Kanazawa University

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