The effect of insulin lispro on glycemic control in a large patient cohort.
Artikel i vetenskaplig tidskrift, 2009

BACKGROUND: The use of rapid-acting insulin analogs and regular insulin differs considerably in countries throughout the world. We therefore studied how glycemic control has been affected by using insulin lispro in clinical practice over 5 years in 14 hospitals in Sweden. METHODS: We used a time period when most patients had not changed the basal insulin, but only the mealtime insulin. Accordingly the most recent years were not suitable since many patients had changed basal insulin from NPH to glargine or determir. We therefore analyzed the metabolic consequences on glycosylated hemoglobin (HbA1c) when changing from regular insulin to insulin lispro from 1997 and during the following 5 years. We studied 1,069 patients with diabetes taking NPH insulin as basal insulin and at least three daily injections of regular insulin, of whom 423 changed their mealtime insulin to insulin lispro and 646 controls who continued with regular insulin. RESULTS: Patients changing to insulin lispro on average decreased by 0.19% units more in HbA1c than those remaining on regular insulin. The effect was most pronounced in patients with high HbA1c even after controlling for regression to the mean. A beneficial effect of insulin lispro was also indicated since patients had the same level of HbA1c during a long period of time with regular insulin but then dropped when changing to insulin lispro. CONCLUSIONS: This study indicates that insulin lispro has had a beneficial and persisting effect on glycemic control when used in patients with diabetes on multiple daily injections of insulin in clinical practice.

Sweden

analogs & derivatives

Insulin

therapeutic use

blood

Glycosylated

Follow-Up Studies

drug therapy

Male

Diabetes Mellitus

Humans

Hypoglycemic Agents

Cohort Studies

therapeutic use

metabolism

Type 1

Female

drug effects

therapeutic use

Homeostasis

Insulin

Middle Aged

Hemoglobin A

metabolism

Blood Glucose

NPH

Författare

Marcus Lind

Göteborgs universitet

Martin Fahlén

Kungälv Hospital

Michael Happich

Lilly Deutschland GmbH

Anders Odén

Chalmers, Matematiska vetenskaper, matematisk statistik

Göteborgs universitet

Björn Eliasson

Göteborgs universitet

Diabetes Technology and Therapeutics

1520-9156 (ISSN)

Vol. 11 1 51-6

Ämneskategorier

Endokrinologi och diabetes

DOI

10.1089/dia.2007.0297

PubMed

19132856