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[IP] Research Study: Interruption of CSII (lispro v humalog)

Sheesh, I sure hope they didn't spend what could have been CURE-related 
research dollars on this study.  I feel quite certain most pumpers on this 
list could have told them half this information at least!  Ellen H. Ullman

J Clin Endocrinol Metab 1999 Aug;84(8):2673-8 

Comparison of metabolic deterioration between insulin analog and regular 
insulin after a 5-hour interruption of a continuous subcutaneous insulin 
infusion in type 1 diabetic patients.

Guerci B, Meyer L, Salle A, Charrie A, Dousset B, Ziegler O, Drouin P

Centre d'Investigation Clinique-INSERM/Centre Hospitalier Universitaire 
de NANCY-Hopital Jeanne d'Arc, Toul, France. email @ redacted 

[Medline record in process]

An interruption of continuous sc insulin infusion (CSII) of the insulin 
analog lispro should result in a more rapid metabolic deterioration of 
type 1 diabetic patients because of its pharmacokinetic characteristics. 
We analyzed the metabolic changes occurring during a 5-h interruption of 
CSII and the 5 h after restarting the pump in 10 type 1 diabetic 
patients. The study was a randomized, cross-over, open label design 
comparing insulin analog [Lispro (LP)] and regular insulin [Velosuline 
(VE)]. Plasma glucose, free insulin, glucagon, betahydroxybutyrate 
(beta-OHB), and nonesterified fatty acids (NEFA) were measured every 
hour from 0700 h (time zero) to 1700 h (600 min). After stopping CSII, 
the plasma glucose level was significantly higher in the LP group than 
in the VE group (P < 0.05-0.01). The plasma free insulin level decreased 
significantly with the two treatments, but was significantly lower with 
LP than with VE (P < 0.05-0.01). Plasma NEFA increased more rapidly and 
was significantly higher in the LP group than in the VE group (P < 
0.01-0.05). Plasma beta-OHB increased earlier with LP, but was not 
statistically different between the treatments. After restarting the 
pump, plasma glucose decreased with LP, but continued to increase with 
VE, and the plasma free insulin peak occurred earlier and was greater 
with LP than with VE (P < 0.05). Plasma NEFA and beta-OHB levels 
decreased significantly with the two treatments, but more dramatically 
with LP treatment. Thus, a short interruption of Lispro in CSII is 
associated with an earlier, greater metabolic deterioration, but Lispro 
corrected this metabolic deterioration more effectively. 

PMID: 10443658, UI: 99371258
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