Treatment with insulin lispro changes the insulin profile but does not affect the plasma concentrations of IGF-I and IGFBP-1 in type 1 diabetes

• Published in: Clinical endocrinology (Oxford) 2001-07, Vol.55 (1), p.107-112
• Main Authors: Hedman, C.A., Orre-Pettersson, A.-C., Lindström, T., Arnqvist, H.J.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Glucose - metabolism; Cross-Over Studies; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - drug therapy; Female; Hormones. Endocrine system; Humans; Hypoglycemic Agents - therapeutic use; Insulin - analogs & derivatives; Insulin - blood; Insulin - therapeutic use; Insulin Lispro; Insulin-Like Growth Factor Binding Protein 1 - blood; Insulin-Like Growth Factor I - metabolism; Male; Medical sciences; MEDICIN; MEDICINE; Middle Aged; Pharmacology. Drug treatments
• ISSN: 0300-0664; 1365-2265; 1365-2265
• DOI: 10.1046/j.1365-2265.2001.01327.x

OBJECTIVE IGF‐I levels in patients with type 1 diabetes without endogenous insulin production are low. Our aim was to examine whether the plasma insulin profile obtained by treatment with the insulin analogue lispro has a different effect on plasma concentrations of IGF‐I and IGFBP‐1 than that seen during treatment with conventional human insulin (regular insulin). DESIGN AND PATIENTS Twelve patients with type 1 diabetes, age 47·8 ± 2·4 years (mean ± SEM), body mass index 26·5 ± 1·0 kg/m2, diabetes duration 30·5 ± 3·2 years participated in this open label randomized cross‐over study. IGF‐I and IGFBP‐1 levels were measured at the end of 6 weeks treatment with each insulin being administered by a continuous subcutaneous insulin infusion. IGF‐I was measured fasting while IGFBP‐1, free insulin and blood glucose were measured fasting and repeatedly after a morning meal preceded by an insulin bolus dose. RESULTS Lispro gave a marked insulin peak of 135 ± 20 pmol/l 50 minutes after injection. After an initial rapid rise, human regular insulin reached a plateau of approximately 50 pmol/l. The plasma free insulin area under the curve (AUC) from 0710 h to 0910 h was more than twice as large on lispro as on regular insulin (P = 0·01). Plasma IGF‐I concentration was 78·8 ± 10·9 µg/l on lispro and 82·3 ± 10·5 µg/l on human regular insulin (not significant). AUC for IGFBP‐1 did not show a significant difference even when divided from 0710 h to 0910 h and from 0930 h to 1430 h. Blood glucose AUC after administration of the bolus was significantly lower during treatment with lispro (P = 0·006) but glycosylated haemoglobin (HbA1c) was 6·4 ± 0·2% on both therapies. CONCLUSIONS Our results indicate that the effect of lispro on IGF‐I and IGFBP‐1 in patients with type 1 diabetes does not differ from that of human regular insulin.