Issue 132 Item 3 ASPART VS. LISPRO and the Winner IS!

A group of researchers led by Dr Johannes Plank from the Karl-Franzens University of Graz in Austria, compared the pharmacokinetic and pharmacodynamic profiles of insulin aspart and insulin lispro and their effects on postprandial blood glucose excursions in patients with type 1 diabetes. Both insulin aspart and insulin lispro, rapid-acting insulin analogs, control postprandial blood glucose in type 1 diabetic patients, according to a report in the November issue of Diabetes Care.

Dr. Johannes Plank, of Karl-Franzens University, Graz, Austria, and colleagues compared the pharmacokinetic and pharmacodynamic profiles of insulin aspart and insulin lispro in type 1 diabetic subjects. In addition, they examined whether one analog results in favorable effects on prandial blood glucose control.

Twenty-four patients on intensified insulin therapy were included in a randomized, double-blind, two-period, crossover, glucose clamp trial. The patients received an individual need-derived dose of prandial insulin aspart or lispro before a standard mixed meal.

Blood glucose profiles were equivalent in both treatment groups throughout the experiment. "This was supported by comparison with maximum postprandial blood glucose excursions…(estimated ratio aspart/lispro ANOVA: 0.95, 0.97, and 1.01 for [blood glucose excursions from time 0 to 6 h, blood glucose excursions from time 0 to 4 h, and maximum postprandial blood glucose excursions], respectively)," Dr Plank and colleagues explain.

Pharmacokinetic end points were also equivalent between the groups. The authors observed no differences in absorption or elimination for time to maximal insulin concentration, time to half-maximum insulin concentration, or time to decrease to 50% of maximum insulin concentration.

The researchers conclude that the fast-acting insulin analogues, insulin aspart and insulin lispro, are equally effective in controlling postprandial blood glucose excursions. Diabetes Care 2002;25:2053-7