Counterregulatory Hormone Responses and Symptoms During Hypoglycaemia Induced by Porcine, Human Regular Insulin, and Lys(B28), Pro(B29) Human Insulin Analogue (Insulin Lispro) in Healthy Male Volunteers
✍ Scribed by Jacobs, M.A.J.M.; Salobir, B.; Popp-Snijders, C.; Ader, H.; Heine, R.J.
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 278 KB
- Volume
- 14
- Category
- Article
- ISSN
- 0742-3071
No coin nor oath required. For personal study only.
✦ Synopsis
Lys(B28)Pro(B29) human insulin analogue (Lispro) is a newly developed monomeric insulin analogue with a rapid onset and short duration of action. The aim of the study was to compare the thresholds for the counterregulatory responses during a stepwise euglycaemic/hypoglycaemic clamp for insulin lispro (LP), human (H), and porcine (P) insulin in a randomized order in 12 healthy male volunteers (age 22.4 ± 1.7 years, BMI 21.9 ± 1.7 kg m -2 ). A euglycaemic period of 2 h was followed by three hypoglycaemic levels of 60 min each: from 150-210 min at 3.5 mmol l -1 , 240-300 min at 3.0 mmol l -1 , and 330-390 min at 2.5 mmol l -1 . Plasma insulin levels during the 50 mU kg -1 h -1 infusions and blood glucose levels were not significantly different. The glucose requirements (mean ± SD) during the last part of the euglycaemic period (90-120 min) tended to be higher during LP compared to those during H and P; 2239 ± 702 and 1929 ± 769, 1957 ± 725 mg kg -1 , P = 0.067, respectively. The thresholds (blood glucose level at which a sustained elevation of the counterregulatory hormones as compared to the mean at normoglycaemia level 4.0 mmol l -1 , occurs) for the various hormones were very similar during LP, H, and P insulin infusions and occurred at 253.8 ± 56.7, 256.3 ± 55.3 and 257.5 ± 70.0 min for adrenaline; 241.4 ± 80.3, 260.5 ± 82.5 and 225.0 ± 75.9 min for noradrenaline; 307.5 ± 65.5, 304.1 ± 74.1 and 322.5 ± 40.4 min for cortisol; 263.8 ± 50.3, 255.0 ± 63.6 and 249.6 ± 50.9 min for growth hormone; 236.3 ± 78.2, 200.0 ± 73.1 and 226.3 ± 65.5 for pancreatic polypeptide. The autonomic and neuroglycopenic symptoms were elicited at 240 and 300 min, respectively. In conclusion, our data indicate a tendency to a higher biological activity of approximately 10 % for Lispro insulin. During a stepwise euglycaemic/hypoglycaemic clamp, the counterregulatory hormone responses to insulin lispro, human insulin, and porcine insulin were similar.