TREATMENT OF EARLY-MORNING HYPERGLYCEMIA IN TYPE-1 DIABETICS WITH AMORPHOUS ZINC INSULIN (SEMILENTE(R)) AT BEDTIME

Fasting hyperglycemia in insulin-dependent diabetic patients (IDDM) tr eated according to the basal-bolus principle may be due to the fact th at currently available neutral protamine Hagedorn (NPH) insulin prepar ations do not sufficiently meet the increased insulin need in the seco nd part of the night. In the present study, it was investigated whethe r the amorphous zinc insulin Semilente(R) can be used to control fasti ng hyperglycemia in IDDM patients. Ten type 1 diabetic patients with p ersistent fasting hyperglycemia (> 10 mmol/l) participated in the doub le-blind randomized cross-over trial with 2 10-day treatment periods. Night profiles of blood glucose and free insulin concentrations were d etermined at the end of each treatment period. Three doses of regular insulin were given before the meals and NPH insulin and Semilente at 1 0.00 p.m. Nighttime blood glucose and insulin profiles were different under the treatment with Semilente and NPH insulin. Injection of Semil ente at bedtime resulted in higher insulin and lower blood glucose val ues during the second part of the night (p < 0.001 versus Semilente by ANOVA). Semilente injected at bedtime can prevent the early-morning r ise in blood glucose in type I diabetic patients.