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. 2009 Feb;32(2):240-4.
doi: 10.2337/dc08-0595. Epub 2008 Nov 18.

Effect of age of infusion site and type of rapid-acting analog on pharmacodynamic parameters of insulin boluses in youth with type 1 diabetes receiving insulin pump therapy

Karena L Swan  1 , James D Dziura, Garry M Steil, Gayane R Voskanyan, Kristin A Sikes, Amy T Steffen, Melody L Martin, William V Tamborlane, Stuart A Weinzimer
Affiliations

Effect of age of infusion site and type of rapid-acting analog on pharmacodynamic parameters of insulin boluses in youth with type 1 diabetes receiving insulin pump therapy

Karena L Swan et al. Diabetes Care. 2009 Feb.

Abstract

Objective: 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.

Research design and methods: 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.

Results: 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.

Conclusions: 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.

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Figures

Figure 1
Figure 1
Pharmacodynamic profiles. Insulin action, as expressed as GIR, required to maintain euglycemia after a standard bolus of 0.2 unit/kg insulin aspart or lispro. Data are presented as means ± SEM. A: Day 1 of catheter site insertion. B: Day 4 of catheter site insertion.
Figure 2
Figure 2
Pharmacodynamic profiles for all subjects on day 1 versus day 4 of catheter site insertion. Insulin action, as expressed as GIR, required to maintain euglycemia after a standard bolus of 0.2 unit/kg insulin aspart or lispro. Data are presented as means ± SEM.
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