LMC Diabetes and Endocrinology, Toronto, Ontario, Canada.
Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Hannover, Germany.
Diabetes Obes Metab. 2023 Jul;25(7):1964-1972. doi: 10.1111/dom.15063. Epub 2023 May 3.
This study compared the pharmacokinetics, glucodynamics and tolerability following single subcutaneous doses of ultra rapid lispro (URLi) versus Humalog in children (6-11 years), adolescents (12-17 years) and adults (18-64 years) with type 1 diabetes mellitus (T1D).
The study was a randomized, two-period, subject- and investigator-blind, crossover design in participants with T1D. Participants received a 0.2 U/kg bolus dose immediately before a liquid mixed meal tolerance test. Insulin lispro and glucose concentrations were measured.
The study included 13 children, 14 adolescents and 15 adults. Consistently across the age groups, onset of appearance was 4-5 min faster, the early 50% t was reduced by 7-13 min, and exposure in the first 15 min was increased by 3.5-6.5-fold following URLi compared with Humalog (all p < .01). Exposure after 3 h was decreased by 37-58% (p = .02) and the duration was reduced by 56 min (p = .006) in children and 36 min (p = .022) in adolescents with URLi compared with Humalog. The maximum and overall exposure were similar between treatments. Postprandial glucose at 1 h was reduced by 42 mg/dl in children (p = .008), 19 mg/dl (p = .195) in adolescents and 34 mg/dl (p = .018) in adults following URLi versus Humalog. The glucose excursion during a 5-h test meal period was reduced by 16% in children and 9% in adolescents compared with Humalog. URLi was well tolerated in all age groups.
URLi showed an accelerated insulin lispro absorption and greater postprandial glucose reduction compared with Humalog in children, adolescents and adults with T1D.
本研究比较了超快速赖脯胰岛素(URLi)和 Humalog 在儿童(6-11 岁)、青少年(12-17 岁)和成年(18-64 岁)1 型糖尿病(T1D)患者中单次皮下给药后的药代动力学、血糖动力学和耐受性。
该研究是一项在 T1D 患者中进行的随机、双周期、双盲、交叉设计的研究。参与者接受 0.2U/kg 的推注剂量,在接受液体混合餐耐量试验前即刻给予。测量胰岛素赖脯氨酸和葡萄糖浓度。
该研究共纳入 13 名儿童、14 名青少年和 15 名成年人。在所有年龄组中,起效时间均提前 4-5 分钟,早期 50%t1/2 缩短 7-13 分钟,15 分钟内的暴露量增加 3.5-6.5 倍,与 Humalog 相比,URLi (均 P<0.01)。在儿童中,与 Humalog 相比,URLi 使 3 小时后的暴露量降低 37-58%(P=0.02),持续时间缩短 56 分钟(P=0.006);在青少年中,使暴露量降低 36%(P=0.022),持续时间缩短 36 分钟(P=0.022)。与 Humalog 相比,餐后 1 小时的血糖降低 42mg/dl(P=0.008),青少年降低 19mg/dl(P=0.195),成年人降低 34mg/dl(P=0.018)。与 Humalog 相比,在 5 小时的测试餐期间,血糖波动降低 16%在儿童和 9%在青少年中。在所有年龄组中,URLi 均耐受良好。
与 Humalog 相比,URLi 在儿童、青少年和成年 T1D 患者中显示出更快的胰岛素赖脯氨酸吸收和更大的餐后血糖降低。