Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy
OBJECTIVE:--The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy. RESEARCH DESIGN AND METHODS--Seventeen insulin pump-tre...
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| Veröffentlicht in: | Diabetes care 2009-02, Vol.32 (2), p.240-244 |
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| creator | Swan, Karena L Dziura, James D Steil, Garry M Voskanyan, Gayane R Sikes, Kristin A Steffen, Amy T Martin, Melody L Tamborlane, William V Weinzimer, Stuart A |
| description | OBJECTIVE:--The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy. RESEARCH DESIGN AND METHODS--Seventeen insulin pump-treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure. RESULTS:--There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03-0.0004), but the overall area under the GIR curve was similar on day 1 and day 4. CONCLUSIONS:--With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected. |
| doi_str_mv | 10.2337/dc08-0595 |
| format | Article |
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RESEARCH DESIGN AND METHODS--Seventeen insulin pump-treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure. RESULTS:--There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03-0.0004), but the overall area under the GIR curve was similar on day 1 and day 4. CONCLUSIONS:--With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc08-0595</identifier><identifier>PMID: 19017777</identifier><identifier>CODEN: DICAD2</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adolescent ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Changes ; Child ; Clinical Care/Education/Nutrition/Psychosocial Research ; Clinical medicine ; Dextrose ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes therapy ; Equipment Design ; Female ; Glucose ; Glucose Clamp Technique ; Glycated Hemoglobin A - metabolism ; Humans ; Hyperglycemia ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - pharmacokinetics ; Hypoglycemic Agents - therapeutic use ; Hypothyroidism ; Insulin ; Insulin - administration & dosage ; Insulin - analogs & derivatives ; Insulin - therapeutic use ; Insulin Aspart ; Insulin Infusion Systems ; Insulin Lispro ; Kinetics ; Life sciences ; Male ; Medical equipment ; Patient Selection ; Physical examinations ; Physiological apparatus ; Plasma ; Studies ; Teenagers ; Type 1 diabetes ; Youth</subject><ispartof>Diabetes care, 2009-02, Vol.32 (2), p.240-244</ispartof><rights>COPYRIGHT 2009 American Diabetes Association</rights><rights>Copyright American Diabetes Association Feb 2009</rights><rights>Copyright © 2009, American Diabetes Association 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c535t-927c876c9e6756f9e0ac595229c248bcd7ae75fb02cfbb584e949c838855a3cf3</citedby><cites>FETCH-LOGICAL-c535t-927c876c9e6756f9e0ac595229c248bcd7ae75fb02cfbb584e949c838855a3cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19017777$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swan, Karena L</creatorcontrib><creatorcontrib>Dziura, James D</creatorcontrib><creatorcontrib>Steil, Garry M</creatorcontrib><creatorcontrib>Voskanyan, Gayane R</creatorcontrib><creatorcontrib>Sikes, Kristin A</creatorcontrib><creatorcontrib>Steffen, Amy T</creatorcontrib><creatorcontrib>Martin, Melody L</creatorcontrib><creatorcontrib>Tamborlane, William V</creatorcontrib><creatorcontrib>Weinzimer, Stuart A</creatorcontrib><title>Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>OBJECTIVE:--The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy. RESEARCH DESIGN AND METHODS--Seventeen insulin pump-treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure. RESULTS:--There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03-0.0004), but the overall area under the GIR curve was similar on day 1 and day 4. CONCLUSIONS:--With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected.</description><subject>Adolescent</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Changes</subject><subject>Child</subject><subject>Clinical Care/Education/Nutrition/Psychosocial Research</subject><subject>Clinical medicine</subject><subject>Dextrose</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes therapy</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Glucose</subject><subject>Glucose Clamp Technique</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - pharmacokinetics</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Hypothyroidism</subject><subject>Insulin</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - analogs & derivatives</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Aspart</subject><subject>Insulin Infusion Systems</subject><subject>Insulin Lispro</subject><subject>Kinetics</subject><subject>Life sciences</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Patient Selection</subject><subject>Physical examinations</subject><subject>Physiological apparatus</subject><subject>Plasma</subject><subject>Studies</subject><subject>Teenagers</subject><subject>Type 1 diabetes</subject><subject>Youth</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptks1u1DAQxyMEokvhwAuAxY1DiuPEiX1BWkqBSpVYtVshTpbjjBNXiR3spGjfiYfE6S4UpHokz8j-zV-ajyR5meETkufVu0ZhlmLK6aNklfGcppQW7HGywlnBU8o5OUqehXCDMS4Kxp4mRxnHWRXPKvl1pjWoCTmN1i0s7tzqORhn0ZWZAEnboO1uvPu5lKNp0rWajG3R2sretShym076QSrX7KwcjEIb6eUAE_iwlwtzbyz64Po5QEAx_O7mqUPfTLzupDP00cg6ZgR0CQrM7aL_J28zDyPaduDluHuePNGyD_Di4I-T609n29Mv6cXXz-en64tU0ZxOKSeVYlWpOJQVLTUHLFVsDiFckYLVqqkkVFTXmChd15QVwAuuWM4YpTJXOj9O3u91x7keoFFgJy97MXozSL8TThrx_481nWjdrSAlYSUro8Cbg4B3P2YIk7hxs48dC4KQHGe0zHmE0j3Uyh6EsdpFLdWCjbX2zoI28Xkd58nijAsW-ZMH-GgNxLY_mPB2n6C8C8GD_ltBhsWyOGJZHLEsTmRf_VvyPXnYlHuxzrTdT-NBNIehLYGS8SEnIlqBI_t6z2rphGy9CeL6iuBsqZyVnLH8Nyn510w</recordid><startdate>20090201</startdate><enddate>20090201</enddate><creator>Swan, 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of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy</title><author>Swan, Karena L ; Dziura, James D ; Steil, Garry M ; Voskanyan, Gayane R ; Sikes, Kristin A ; Steffen, Amy T ; Martin, Melody L ; Tamborlane, William V ; Weinzimer, Stuart A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c535t-927c876c9e6756f9e0ac595229c248bcd7ae75fb02cfbb584e949c838855a3cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Changes</topic><topic>Child</topic><topic>Clinical Care/Education/Nutrition/Psychosocial Research</topic><topic>Clinical medicine</topic><topic>Dextrose</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes therapy</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Glucose</topic><topic>Glucose Clamp Technique</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - pharmacokinetics</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Hypothyroidism</topic><topic>Insulin</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - analogs & derivatives</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Aspart</topic><topic>Insulin Infusion Systems</topic><topic>Insulin Lispro</topic><topic>Kinetics</topic><topic>Life sciences</topic><topic>Male</topic><topic>Medical equipment</topic><topic>Patient Selection</topic><topic>Physical examinations</topic><topic>Physiological apparatus</topic><topic>Plasma</topic><topic>Studies</topic><topic>Teenagers</topic><topic>Type 1 diabetes</topic><topic>Youth</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swan, Karena L</creatorcontrib><creatorcontrib>Dziura, James D</creatorcontrib><creatorcontrib>Steil, Garry M</creatorcontrib><creatorcontrib>Voskanyan, Gayane R</creatorcontrib><creatorcontrib>Sikes, Kristin A</creatorcontrib><creatorcontrib>Steffen, Amy T</creatorcontrib><creatorcontrib>Martin, Melody L</creatorcontrib><creatorcontrib>Tamborlane, William V</creatorcontrib><creatorcontrib>Weinzimer, Stuart A</creatorcontrib><collection>AGRIS</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Agricultural Science Collection</collection><collection>Health & 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A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2009-02-01</date><risdate>2009</risdate><volume>32</volume><issue>2</issue><spage>240</spage><epage>244</epage><pages>240-244</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><coden>DICAD2</coden><abstract>OBJECTIVE:--The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy. RESEARCH DESIGN AND METHODS--Seventeen insulin pump-treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure. RESULTS:--There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03-0.0004), but the overall area under the GIR curve was similar on day 1 and day 4. CONCLUSIONS:--With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>19017777</pmid><doi>10.2337/dc08-0595</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2009-02, Vol.32 (2), p.240-244 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_highwire_diabetes_diacare_32_2_240 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adolescent Blood Glucose - drug effects Blood Glucose - metabolism Changes Child Clinical Care/Education/Nutrition/Psychosocial Research Clinical medicine Dextrose Diabetes Diabetes Mellitus, Type 1 - drug therapy Diabetes therapy Equipment Design Female Glucose Glucose Clamp Technique Glycated Hemoglobin A - metabolism Humans Hyperglycemia Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - pharmacokinetics Hypoglycemic Agents - therapeutic use Hypothyroidism Insulin Insulin - administration & dosage Insulin - analogs & derivatives Insulin - therapeutic use Insulin Aspart Insulin Infusion Systems Insulin Lispro Kinetics Life sciences Male Medical equipment Patient Selection Physical examinations Physiological apparatus Plasma Studies Teenagers Type 1 diabetes Youth |
| title | Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy |
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