Italian multicentre study of intensive therapy with insulin lispro in 1184patients with Type 1 diabetes

Insulin lispro is absorbed more rapidly and has a shorter duration of actio n than regular human insulin. It improves glycaemic control but large-scale studies are required to identify regimens that optimise efficacy and safet y with local dietary habits. This study involved 1184 Italian patients with Type a diabetes, randomised to insulin lispro (n=586) or regular human ins ulin (n=598) as pre-meal bolus for 3 months. Optimisation of basal NPH insu lin was carried out in both groups, The number of administrations of NPH in sulin was increased when using insulin lispro but, because basal and bolus insulins were mixed before meals, the total number of injections per day wa s unchanged. Compliance to administration time was significantly (p <0.001) greater with insulin lispro than with regular human insulin. Post-prandial blood glucose levels were lower with insulin lispro after breakfast (p <0. 001), lunch (p <0.005) and dinner (p <0.001), The HbA(1c) level was decreas ed from baseline by both insulins, but the percent increase in patients wit h acceptable (<8 %) HbA(1c) was greater with insulin lispro. While frequenc y of hypoglycaemia was decreased from baseline by both insulins, the propor tion of episodes classified as severe was significantly increased from base line with regular human insulin, but not with insulin lispro, Thus, compare d with regular human insulin, improved glycaemic control was achieved with insulin lispro without an increase in severe hypoglycaemia, (C) 2001, Editr ice Kurtis.