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Comparative effects of insulin glulisine and lispro on postprandial plasma glucose and lipid profile in Japanese patients with type 2 diabetes mellitus

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Abstract

Objective

The control of postprandial plasma glucose (PPG) excursions is critical in the prevention of diabetic complications. Controversy remains on the differences in postprandial actions of insulin glulisine and lispro. The aim of this study was to define the differences in the efficacy of these two insulin analogues on PPG.

Methods

The study subjects were 20 in-hospital patients with type 2 diabetes mellitus (T2DM). Plasma glucose (PG) was tightly controlled with basal insulin and insulin glulisine or lispro, and then glulisine or lispro were switched to the other insulin analog every other day for 6 study days. PG was measured before breakfast and 0.5-, 1-, and 2 h-postprandial during the study. Postprandial plasma C-peptide and lipids were analyzed in the first 2 days of the study. Postprandial increments in each parameter were compared between glulisine and lispro.

Results

Whereas the median value of 0.5 h-Δ-PPG was comparable in glulisine and lispro, the 1 h-Δ-PPG was significantly lower with lispro than with glulisine (41 vs 53 mg/dl, respectively, p = 0.03). Similarly, the 2 h-Δ-PPG with lispro was 10 mg/dl lower than that with glulisine (35 vs 45 mg/dl, respectively, p = 0.05). In parallel with PPG, Δ-C-peptide at 1- and 2 h-postprandial were significantly lower with lispro than glulisine (0.50 vs 0.75 ng/ml, respectively, and 0.55 vs 0.75 ng/ml, respectively). The increment in LDL-C and HDL-C was significantly lower with lispro than with glulisine at 0.5 h-postprandial.

Conclusion

Insulin lispro seems superior to glulisine in the control of PPG in Japanese patients with T2DM.

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Author information

Authors and Affiliations

  1. Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, 910-1193, Japan

    Mika Yamada, Jinya Suzuki, Takahiro Nakaya, Mai Ichikawa, Katsushi Yamamoto, Michiko Imagawa, Satsuki Sato, Miki Fujii, Yasuo Zenimaru, Tadashi Konoshita & Tamotsu Ishizuka

Authors
  1. Mika Yamada
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  2. Jinya Suzuki
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  3. Takahiro Nakaya
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  4. Mai Ichikawa
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  5. Katsushi Yamamoto
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  6. Michiko Imagawa
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  7. Satsuki Sato
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  8. Miki Fujii
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  9. Yasuo Zenimaru
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  10. Tadashi Konoshita
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  11. Tamotsu Ishizuka
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Contributions

MY and JS designed the study and all authors contributed to data collection. Material preparation and analysis were performed by MY and JS. The first draft of the manuscript was written by MY and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jinya Suzuki.

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Conflict of interest

Authors Mika Yamada, Jinya Suzuki, Takahiro Nakaya, Mai Ichikawa, Katsushi Yamamoto, Michiko Imagawa, Satsuki Sato, Miki Fujii, Yasuo Zenimaru, Tadashi Konoshita, and Tamotsu Ishizuka declare that they have no conflict of interest.

Ethical approval

The study was conducted in accordance with the Helsinki Declaration of 1964 and later versions, and was reviewed and approved by the ethics committee of the University of Fukui. Approval number: 20128023. Date of approval: November 20, 2012.

Informed consent

Informed consent was obtained from all patients prior to their participation in this study.

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Yamada, M., Suzuki, J., Nakaya, T. et al. Comparative effects of insulin glulisine and lispro on postprandial plasma glucose and lipid profile in Japanese patients with type 2 diabetes mellitus. Diabetol Int 12, 330–335 (2021). https://doi.org/10.1007/s13340-020-00475-1

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  • DOI: https://doi.org/10.1007/s13340-020-00475-1

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