COUNTERREGULATORY HORMONE RESPONSES AND SYMPTOMS DURING HYPOGLYCEMIA-INDUCED BY PORCINE, HUMAN REGULAR INSULIN, AND LYS(B28), PRO(B29) HUMAN INSULIN ANALOG (INSULIN LISPRO) IN HEALTHY MALE-VOLUNTEERS

Lys(B28)Pro(B29) human insulin analogue (Lispro) is a newly developed monomeric insulin analogue with a vapid onset and short duration of ac tion. The aim of the study was to compare the thresholds for the count erregulatory responses during a stepwise euglycaemic/hypoglycaemic cla mp for insulin lispro (LP), human (H), and porcine (P) insulin in a ra ndomized 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 b y three hypoglycaemic levels of 60 min each: from 150-210 min at 3.5 m mol 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 a cid blood glucose levels were not significantly different. The glucose requirements (mean +/- SD) during the last part of the euglycaemic pe riod (90-120 min) tended to be higher during LP compared to those duri ng 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 s ustained elevation of the counterregulatory hormones as compared to th e 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 f or 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 we re elicited at 240 and 300 min, respectively. In conclusion, our data indicate a tendency to a higher biological activity of approximately 1 0 % for Lispro insulin. During a stepwise euglycaemic/hypoglycaemic cl amp, the counterregulatory hormone responses to insulin lispro, human insulin, and porcine insulin were similar.