Homko Carol, Deluzio Antonio, Jimenez Carolyn, Kolaczynski Jerzy W, Boden Guenther
General Clinical Research Center and Division of Endocrinology/Diabetes/Metabolism, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.
Diabetes Care. 2003 Jul;26(7):2027-31. doi: 10.2337/diacare.26.7.2027.
To compare insulin levels and actions in patients with type 1 diabetes after subcutaneous injection of the rapid-acting insulin analogs aspart and lispro.
Seven C-peptide-negative patients with type 1 diabetes (two men and five women) were studied at the General Clinical Research Center at Temple University Hospital two times, 1 month apart. Their plasma glucose was normalized overnight by intravenous infusion of insulin. The next morning, they received subcutaneous injections of either aspart or lispro (9.4 +/- 1.9 U) in random order. For the next 4-5 h, their plasma glucose was clamped at approximately 5.5 mmol/l with a variable infusion of 20% glucose. The study was terminated after 8 h.
Both insulin analogs produced similar serum insulin levels (250-300 pmol/l) at approximately 30 min and disappeared from serum after approximately 4 h. Insulin aspart and lispro had similar effects on glucose and fat metabolism. Effects on carbohydrate metabolism (glucose uptake, glucose oxidation, and endogenous glucose production) peaked after approximately 2-3 h and disappeared after approximately 5-6 h. Effects on lipid metabolism (plasma free fatty acid, ketone body levels, and free fatty acid oxidation) appeared to peak earlier (at approximately 2 h) and disappeared earlier (after approximately 4 h) than the effects on carbohydrate metabolism.
We conclude that both insulin aspart and lispro are indistinguishable from each other with respect to blood levels and that they are equally effective in correcting abnormalities in carbohydrate and fat metabolism in patients with type 1 diabetes.
比较1型糖尿病患者皮下注射速效胰岛素类似物门冬胰岛素和赖脯胰岛素后的胰岛素水平及作用。
7例C肽阴性的1型糖尿病患者（2例男性，5例女性）在天普大学医院综合临床研究中心接受了两次研究，间隔1个月。通过静脉输注胰岛素使他们的血浆葡萄糖在夜间恢复正常。次日早晨，他们随机接受皮下注射门冬胰岛素或赖脯胰岛素（9.4±1.9 U）。在接下来的4 - 5小时内，通过可变输注20%葡萄糖将他们的血浆葡萄糖维持在约5.5 mmol/L。8小时后研究结束。
两种胰岛素类似物在大约30分钟时产生相似的血清胰岛素水平（250 - 300 pmol/L），并在大约4小时后从血清中消失。门冬胰岛素和赖脯胰岛素对葡萄糖和脂肪代谢有相似的作用。对碳水化合物代谢（葡萄糖摄取、葡萄糖氧化和内源性葡萄糖生成）的作用在大约2 - 3小时后达到峰值，并在大约5 - 6小时后消失。对脂质代谢（血浆游离脂肪酸、酮体水平和游离脂肪酸氧化）的作用似乎比碳水化合物代谢的作用更早达到峰值（约2小时）且更早消失（约4小时后）。
我们得出结论，门冬胰岛素和赖脯胰岛素在血药水平方面彼此无差异，并且它们在纠正1型糖尿病患者碳水化合物和脂肪代谢异常方面同样有效。
