NIGHTTIME INSULIN KINETICS AND GLYCEMIC CONTROL IN TYPE-1 DIABETES PATIENTS FOLLOWING ADMINISTRATION OF AN INTERMEDIATE-ACTING LISPRO PREPARATION

OBJECTIVE --To determine insulin kinetics and overnight glycemic contr ol after bedtime administration of a new intermediate-acting insulin p reparation called neutral protamine lispro (NPL), RESEARCH DESIGN AND METHODS - We studied 12 patients with well-controlled type 1 diabetes. The study had a double-blind, randomized, crossover design. After a l ead-in period of 10-14 days two experiments were carried out with an i nterval of 2-7 days. During these experiments overnight insulin kineti cs and fasting blood glucose levels were studied after evening adminis tration of NPH insulin and NPL. Blood glucose levels <3.8 mmol/l were treated by means of a variable infusion of a 20% glucose solution. RES ULTS - A trend toward a shorter time to peak insulin concentration was observed after administration of NPL (P = 0.07), No differences betwe en NPH and NPL were detected in the total area under the curve (AUG) f or insulin, in insulin levels before breakfast, or in glucose levels b efore breakfast (P = 0.5, 0.6, and 0.4, respectively), CONCLUSIONS - W e detected no major differences between NPH and NPL in the total AUC f or insulin, prebreakfast glucose levels, or prebreakfast insulin level s. Therefore, we conclude that NPH and NPL are equally effective in co ntrolling overnight glycemia.