Pharmacokinetics of insulin aspart in pump-treated subjects with type 1 diabetes: reproducibility and effect of age, weight, and duration of diabetes

Ahmad Haidar, Daniela Elleri, Kavita Kumareswaran, Lalantha Leelarathna, Janet M Allen, Karen Caldwell, Helen R Murphy, Malgorzata E Wilinska, Carlo L Acerini, Mark L Evans, David B Dunger, Marianna Nodale, Roman Hovorka

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Abstract

Insulin aspart, lispro, or glulisine are recommended in pump-treated type 1 diabetes (T1D). Aspart pharmacokinetics has been studied (1), but little is known about its reproducibility and associations with anthropometric and clinical factors.

We analyzed retrospectively data collected in 70 pump-treated subjects with T1D, comprising 39 females, 46 young, with mean (SD) BMI 22.7 (4.2) kg/m2, A1C 8.1% (1.3) (65.3 [14.4] mmol/mol), and total daily insulin 0.8 (0.3) units/kg/day, who were undergoing investigations, with ethical approval, of closed-loop insulin delivery. Participants/guardians signed consent/assent as appropriate. Participants were admitted twice to the research facility, 1–6 weeks apart, for 15–37 h, and consumed 1–4 meals accompanied by prandial insulin aspart. Basal aspart was delivered using closed-loop insulin delivery or conventional pump therapy. Venous blood samples were collected every 30–60 min to measure plasma insulin (Invitron, Monmouth, U.K.).

From 5,804 plasma insulin measurements, we estimated, using a two-compartment model, the time-to-peak plasma insulin concentration (tmax [min]), the metabolic clearance rate of insulin (MCR in mL/kg/min), and the background residual plasma insulin concentration (mU/L). Results are presented in Table 1. Sex differences in aspart kinetics were not observed. Aspart pharmacokinetics was weakly influenced by common clinical and anthropometric factors, because less than 20% of intersubject variability was explained by sex, BMI, total daily dose, A1C, and diabetes duration.
Original languageEnglish
Pages (from-to)e173-174
Number of pages2
JournalDiabetes Care
Volume36
Issue number10
DOIs
Publication statusPublished - Oct 2013

Keywords

  • Age Factors
  • Body Weight
  • Diabetes Mellitus, Type 1
  • Female
  • Humans
  • Insulin Aspart
  • Male
  • Retrospective Studies

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