OBJECTIVETo assess the role of adiposity on the pharmacodynamics of basal insulins NPH, detemir, and glargine in type 2 diabetes mellitus (T2DM), as estimated by glucose infusion rate (GIR) and endogenous glucose production (EGP) rate in the euglycemic clamp.RESEARCH DESIGN AND METHODSWe examined the variables that best predicted GIR and EGP in 32-h clamp studies after treatment with subcutaneous injection of 0.4 units/kg neutral protamine Hagedorn insulin (NPH), detemir, and glargine in 18 T2DM subjects (crossover).RESULTSA multiple regression analysis revealed that BMI best predicted GIR variation during the clamp. BMI was inversely correlated with GIR in all three insulin treatments, but was statistically significant in detemir treatment only. BMI correlated positively with residual suppression of EGP in detemir, but not with glargine and NPH treatments.CONCLUSIONSAdiposity blunts the pharmacodynamics of all basal insulins in T2DM. However, as adiposity increases, the effect of detemir is lower versus NPH and glargine.

Differential Effects of Adiposity on Pharmacodynamics of Basal Insulins NPH, Glargine, and Detemir in Type 2 Diabetes mellitus.

PORCELLATI, Francesca;LUCIDI, Paola;MARINELLI ANDREOLI, ANNA;BOLLI, Geremia Brunetto;FANELLI, Carmine Giuseppe
2011-01-01

Abstract

OBJECTIVETo assess the role of adiposity on the pharmacodynamics of basal insulins NPH, detemir, and glargine in type 2 diabetes mellitus (T2DM), as estimated by glucose infusion rate (GIR) and endogenous glucose production (EGP) rate in the euglycemic clamp.RESEARCH DESIGN AND METHODSWe examined the variables that best predicted GIR and EGP in 32-h clamp studies after treatment with subcutaneous injection of 0.4 units/kg neutral protamine Hagedorn insulin (NPH), detemir, and glargine in 18 T2DM subjects (crossover).RESULTSA multiple regression analysis revealed that BMI best predicted GIR variation during the clamp. BMI was inversely correlated with GIR in all three insulin treatments, but was statistically significant in detemir treatment only. BMI correlated positively with residual suppression of EGP in detemir, but not with glargine and NPH treatments.CONCLUSIONSAdiposity blunts the pharmacodynamics of all basal insulins in T2DM. However, as adiposity increases, the effect of detemir is lower versus NPH and glargine.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11391/450095
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