Swan Karena L, Dziura James D, Steil Garry M, Voskanyan Gayane R, Sikes Kristin A, Steffen Amy T, Martin Melody L, Tamborlane William V, Weinzimer Stuart A
Department of Pediatrics, Section of Pediatric Endocrinology, Yale University, New Haven, Connecticut, USA.
Diabetes Care. 2009 Feb;32(2):240-4. doi: 10.2337/dc08-0595. Epub 2008 Nov 18.
The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy.
Seventeen insulin pump-treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure.
There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03-0.0004), but the overall area under the GIR curve was similar on day 1 and day 4.
With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected.
本研究旨在探讨胰岛素类似物类型及注射部位使用时长对接受胰岛素泵治疗的1型糖尿病青少年患者标准胰岛素大剂量注射药效学特征的影响。
17名接受胰岛素泵治疗的1型糖尿病青少年患者，在胰岛素泵植入部位使用第1天和第4天，分别给予0.2单位/千克的门冬胰岛素或赖脯胰岛素大剂量注射后，进行了两次正常血糖钳夹试验。维持正常血糖所需的葡萄糖输注速率（GIR）是主要的药效学指标。
第1天和第4天，门冬胰岛素和赖脯胰岛素之间的任何药效学参数均无统计学显著差异。然而，将两组数据合并后发现，与第1天相比，第4天停止外源性葡萄糖输注的时间、胰岛素作用达到最大效应一半的起效时间和消退时间均显著提前（P = 0.03 - 0.0004），但第1天和第4天GIR曲线下的总面积相似。
使用门冬胰岛素和赖脯胰岛素时，随着输注部位使用时长增加，作用峰值出现更早且作用持续时间更短，但总体胰岛素作用不受影响。
