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[IPu] Fw: [IP] abstract from Diabetes Care March 2005



Hi All,
Remember Insulin Aspart is NovoRapid.  (Humolpg is techically called 
Lispro).
BG numbers are quoted in US figues divide by 18 to give m mls for us.

Janette

from: <email @ redacted>
To: <email @ redacted>
Sent: Saturday, February 26, 2005 12:48 PM
Subject: [IP] abstract from Diabetes Care March 2005


 Continuous Subcutaneous Insulin Infusion (CSII) of Insulin Aspart Versus
Multiple Daily Injection of Insulin Aspart/Insulin G..
Clinical Care/Education/Nutrition
Original Article
Continuous Subcutaneous Insulin Infusion (CSII) of Insulin Aspart Versus
Multiple Daily Injection of Insulin Aspart/Insulin Glargine in Type 1 
Diabetic
Patients Previously Treated With CSII
Irl B. Hirsch, MD1, Bruce W. Bode, MD2, Satish Garg, MD3, Wendy S. Lane, 
MD4,
Allen Sussman, MD5, Peter Hu, PhD6, Olga M. Santiago, MD6 and Jerzy W.
Kolaczynski, MD7 for the Insulin Aspart CSII/MDI Comparison Study Group
1 University of Washington, Seattle, Washington
2 Atlanta Diabetes Associates, Atlanta, Georgia
3 Barbara Davis Center for Childhood Diabetes, Denver, Colorado
4 Mountain Diabetes and Endocrine Center, Asheville, North Carolina
5 Rainier Clinical Research Center, Renton, Washington
6 Novo Nordisk Pharmaceuticals, Princeton, New Jersey
7 University of Medicine and Dentistry of New Jersey, Robert Wood Johnson
Medical School, New Brunswick, New Jersey
Address correspondence and reprint requests to Irl B. Hirsch, MD, University
of Washington Medical Center, 1959 NE Pacific St., Box 356176, Seattle, WA
98195. E-mail: email @ redacted

OBJECTIVEbMultiple daily injection (MDI) therapy of bolus insulin aspart 
and
basal insulin glargine was compared with continuous subcutaneous insulin
infusion (CSII) with aspart in type 1 diabetic patients previously treated
with CSII.

RESEARCH DESIGN AND METHODSbOne hundred patients were enrolled in a
randomized, multicenter, open-label, crossover study. After a 1-week run-in
period with
aspart by CSII, 50 subjects were randomly assigned to MDI therapy (aspart
immediately before each meal and glargine at bedtime) and 50 subjects
continued
CSII. After 5 weeks of the first treatment, subjects crossed over to the
alternate treatment for 5 weeks. During the last week of each treatment
period,
subjects wore a continuous glucose monitoring system for 48b72 h.

RESULTSbMean serum fructosamine levels were significantly lower after CSII
therapy than after MDI therapy (343 B1 47 vs. 355 B1 50 B5mol/l, 
respectively;
P = 0.0001). Continuous glucose monitoring profiles over a 24-h time period 
showed
that glucose exposure was 24 and 40% lower for CSII than MDI as measured by
area under the curve (AUC) glucose 80 mg/dl (1,270 B1 742 vs. 1,664 B1 1,039
mg B7
h B7 dlb1; P < 0.001) and AUC glucose 140 mg/dl (464 B1 452 vs. 777 B1 746
mg B7
h B7 dl" "1, CSII vs. MDI, respectively; P < 0.001). Similar percentages of
subjects reported hypoglycemic episodes (CSII: 92%, MDI: 94%) and nocturnal
(12:00 A.M. to 8:00 A.M.) hypoglycemic episodes (CSII: 73%, MDI: 72%). Major
hypoglycemia was infrequent (CSII: two episodes, MDI: five episodes).

CONCLUSIONS" "In a trial of short duration, CSII therapy with insulin 
aspart
resulted in lower glycemic exposure without increased risk of hypoglycemia,
as compared with MDI with insulin aspart and glargine.
Abbreviations: AUC, area under the curve b" CGMS, continuous glucose
monitoring system b" CSII, continuous subcutaneous insulin infusion b" MDI,
multiple daily injection b" SMBG, self-measured blood glucose
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