Assessing insulin effectiveness at the end of the day Once-daily versus twice-daily insulin glargine injection英文文献资料.docVIP

Vol.2, No.2, 203-207 (2012) Journal of Diabetes Mellitus /10.4236/jdm.2012.22032 Assessing insulin effectiveness at the end of the day: Once-daily versus twice-daily insulin glargine injection Mark R. Burge , Eric R. Schroeder , Stephen Mitchell 1* 2 3 1 Department of Medicine, Division of Endocrinology and Metabolism, University of New Mexico Health Sciences Center, Albu- * querque, USA; 2 Corresponding Author: mburge@ Division of Cardiovascular Medicine, South Miami Hospital, Miami, USA Department of Medicine, Endocrinology, The Vancouver Clinic, Vancouver, USA 3 Received 11 February 2012; revised 15 March 2012; accepted 23 April 2012 ABSTRACT Keywords: Insulin Injection; Timing; Insulin Glargine; Basal Insulin; Type 1 Diabetes Objective: Evidence supporting the twice-daily administration of insulin glargine as an app- roach to address its waning effectiveness at the end of a 24 hour period is sparse. We hypothe- sized that insulin concentrations determined during the last four hours of a 24 hour period would be greater when identical doses of insulin glargine were administered twice-daily as com- pared to once-daily among type 1 diabetes pati- ents. Research Methods: Ten subjects with in- sulin deficient type 1 diabetes were admitted for two 38-hour studies at least one week apart. Patients received full-dose insulin glargine once daily at 0800 and half-dose insulin glargine twice-daily at 0800 and 2000 for at least one week in random order prior to overnight studies. Overnight glucose was stabilized with intrave- nous insulin on the evening prior to study, and subjects fasted and did not receive short acting insulin during the study period. Insulin concen- trations were assessed every 30 minutes with an ultra-sensitive assay between study hours 20 and 24. Results: Insulin concentra