Improved glycemic control can be better maintained with insulin lispro than with human regular insulin

We have recently demonstrated in are uncontrolled study that glycemic contr ol can he improved, when type 1 diabetic patients are transferred to insuli n lispro and basal insulin regimen is optimized. We examined whether the be tter control can be maa maintained if the patients are transferred back to regular human insulin regimen, Eighty-four type 1 patients (age 35+/-1 yrs, diabetes duration 16+/-1 yrs) from Sweden, Finland, Spain and Italy partic ipated in the study, In an open study, the patients were randomised either to continue with insulin lispro or with regular human insulin for four mont hs, As compared to changes duping insulin lispro therapy, transfer to regul ar human insulin resulted in decreased dosage and frequency of injections o f basal insulin (p<0.001 in both), associated with an increased dosage of s hort-acting insulin (p<0.001), with the total insulin dosage remaining unch anged. The mean blood glucose (p<0.05) and HbA(1c) level (p<0.01) rose in t he regular insulin group, but remained unchanged in insulin lispro treated patients, Body weight or hypoglycemia rate did not change in either group. The treatment satisfaction was worsened in the human regular insulin group (p<0.001). In conclusion, in type 1 diabetic patients transfer from insulin lispro to human regular insulin results in a worse metabolic control and t reatment satisfaction without any change in hypoglycemia rate. Diab. Nutr. Metab. 11: 194-199, 1998. (C) 1998, Editrice Kurtis.