Pharmacokinetics and Pharmacodynamics of Therapeutic Doses of Basal Insulins NPH, Glargine, and Detemir After 1 Week of Daily Administration at Bedtime in Type 2 Diabetic Subjects
Open Access
- 20 May 2011
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 34 (6), 1312-1314
- https://doi.org/10.2337/dc10-1911
Abstract
OBJECTIVE: To compare the pharmacokinetics and pharmacodynamics of NPH, glargine, and detemir insulins in type 2 diabetic subjects. RESEARCH DESIGN AND METHODS: This study used a single-blind, three-way, cross-over design. A total of 18 type 2 diabetic subjects underwent a euglycemic clamp for 32 h after a subcutaneous injection of 0.4 units/kg at 2200 h of either NPH, glargine, or detemir after 1 week of bedtime treatment with each insulin. RESULTS: The glucose infusion rate area under the curve0–32 h was greater for glargine than for detemir and NPH (1,538 ± 688; 1,081 ± 785; and 1,170 ± 703 mg/kg, respectively; P < 0.05). Glargine suppressed endogenous glucose production more than detemir (P < 0.05) and similarly to NPH (P = 0.16). Glucagon, C-peptide, free fatty acids, and β-hydroxy-butyrate were more suppressed with glargine than detemir. All 18 subjects completed the glargine study, but two subjects on NPH and three on detemir interrupted the study because of plasma glucose >150 mg/dL. CONCLUSIONS: Compared with NPH and detemir, glargine provided greater metabolic activity and superior glucose control for up to 32 h.Keywords
This publication has 10 references indexed in Scilit:
- Mechanisms of Insulin Resistance After Insulin-Induced Hypoglycemia in Humans: The Role of LipolysisDiabetes, 2010
- Nocturnal Glucose Metabolism after Bedtime Injection of Insulin Glargine or Neutral Protamine Hagedorn Insulin in Patients with Type 2 DiabetesJournal of Clinical Endocrinology & Metabolism, 2008
- Beyond the Era of NPH Insulin—Long-Acting Insulin Analogs: Chemistry, Comparative Pharmacology, and Clinical ApplicationDiabetes Technology & Therapeutics, 2008
- A randomised, 52-week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetesDiabetologia, 2008
- Comparison of Pharmacokinetics and Dynamics of the Long-Acting Insulin Analogs Glargine and Detemir at Steady State in Type 1 DiabetesDiabetes Care, 2007
- Time‐action profile of insulin detemir and NPH insulin in patients with type 2 diabetes from different ethnic groups*Diabetes, Obesity and Metabolism, 2006
- Normal Data from Designs with Three or More TreatmentsPublished by Wiley ,2002
- Assessment of methods for improving tracer estimation of non-steady-state rate of appearanceJournal of Applied Physiology, 1999
- Evidence for a Circadian Rhythm of Insulin Sensitivity in Patients With NIDDM Caused by Cyclic Changes in Hepatic Glucose ProductionDiabetes, 1996
- The “Dawn Phenomenon” — A Common Occurrence in Both Non-Insulin-Dependent and Insulin-Dependent Diabetes MellitusNew England Journal of Medicine, 1984