Administration of Lispro insulin with meals improves glycemic control, increases circulating leptin, and suppresses ghrelin, compared with regular/NPH insulin in female patients with type 1 diabetes

Steven C. Griffen, Kimberly Oostema, Kimber Stanhope, James Graham, Dennis M Styne, Nicole Glaser, David E. Cummings, Matthew H. Connors, Peter J Havel

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Context: Overweight and obesity are overrepresented in adolescents with type 1 diabetes mellitus (T1DM). Exogenous insulin administration often poorly reproduces normal insulin patterns and may less effectively regulate leptin and ghrelin, two hormones involved in the control of appetite and adiposity. Objective: The objective of the study was to determine whether insulin regimens that better replicate normal insulin patterns and augment postprandial nutrient disposal may help normalize leptin and ghrelin and improve body weight regulation. Design, Setting, and Participants: Ten young women with T1DM were studied in this 2-wk prospective, balanced crossover-design study at the University of California, Davis. Intervention: Participants received either a single injection of regular + NPH insulin (R+N) or two mealtime injections of Lispro insulin in randomized order on 2 separate days. Meal composition and total insulin administered were the same on both treatment days. Main Outcome Measures: Plasma glucose, insulin, leptin, and ghrelin concentrations were monitored over the 10-h study period. Results: Lispro produced two distinct mealtime peaks of insulin, compared with one prolonged rise with R+N. Lispro reduced postprandial hyperglycemia and total glucose area under the curve. Leptin increased more on the Lispro (2.7 ± 0.7 vs. 0.7 ± 0.5 ng/ml, P = 0.02). Ghrelin was more suppressed after lunch with Lispro (P = 0.004). Conclusions: Injection of Lispro insulin with meals produces more physiological insulin patterns, better glucose control, and improved leptin and ghrelin regulation than R+N. More closely mimicking normal insulin, leptin, and ghrelin responses to meals with fast-acting insulin may have implications for body weight regulation in T1DM.

Original languageEnglish (US)
Pages (from-to)485-491
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume91
Issue number2
DOIs
StatePublished - Feb 2006

Fingerprint

Insulin Lispro
Isophane Insulin
Ghrelin
Medical problems
Leptin
Type 1 Diabetes Mellitus
Meals
Insulin
Glucose
Cross-Over Studies
Injections
Body Weight
Lunch
Adiposity
Appetite
Nutrients
Hyperglycemia
Area Under Curve

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Administration of Lispro insulin with meals improves glycemic control, increases circulating leptin, and suppresses ghrelin, compared with regular/NPH insulin in female patients with type 1 diabetes. / Griffen, Steven C.; Oostema, Kimberly; Stanhope, Kimber; Graham, James; Styne, Dennis M; Glaser, Nicole; Cummings, David E.; Connors, Matthew H.; Havel, Peter J.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 91, No. 2, 02.2006, p. 485-491.

Research output: Contribution to journalArticle

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abstract = "Context: Overweight and obesity are overrepresented in adolescents with type 1 diabetes mellitus (T1DM). Exogenous insulin administration often poorly reproduces normal insulin patterns and may less effectively regulate leptin and ghrelin, two hormones involved in the control of appetite and adiposity. Objective: The objective of the study was to determine whether insulin regimens that better replicate normal insulin patterns and augment postprandial nutrient disposal may help normalize leptin and ghrelin and improve body weight regulation. Design, Setting, and Participants: Ten young women with T1DM were studied in this 2-wk prospective, balanced crossover-design study at the University of California, Davis. Intervention: Participants received either a single injection of regular + NPH insulin (R+N) or two mealtime injections of Lispro insulin in randomized order on 2 separate days. Meal composition and total insulin administered were the same on both treatment days. Main Outcome Measures: Plasma glucose, insulin, leptin, and ghrelin concentrations were monitored over the 10-h study period. Results: Lispro produced two distinct mealtime peaks of insulin, compared with one prolonged rise with R+N. Lispro reduced postprandial hyperglycemia and total glucose area under the curve. Leptin increased more on the Lispro (2.7 ± 0.7 vs. 0.7 ± 0.5 ng/ml, P = 0.02). Ghrelin was more suppressed after lunch with Lispro (P = 0.004). Conclusions: Injection of Lispro insulin with meals produces more physiological insulin patterns, better glucose control, and improved leptin and ghrelin regulation than R+N. More closely mimicking normal insulin, leptin, and ghrelin responses to meals with fast-acting insulin may have implications for body weight regulation in T1DM.",
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T1 - Administration of Lispro insulin with meals improves glycemic control, increases circulating leptin, and suppresses ghrelin, compared with regular/NPH insulin in female patients with type 1 diabetes

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AU - Oostema, Kimberly

AU - Stanhope, Kimber

AU - Graham, James

AU - Styne, Dennis M

AU - Glaser, Nicole

AU - Cummings, David E.

AU - Connors, Matthew H.

AU - Havel, Peter J

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N2 - Context: Overweight and obesity are overrepresented in adolescents with type 1 diabetes mellitus (T1DM). Exogenous insulin administration often poorly reproduces normal insulin patterns and may less effectively regulate leptin and ghrelin, two hormones involved in the control of appetite and adiposity. Objective: The objective of the study was to determine whether insulin regimens that better replicate normal insulin patterns and augment postprandial nutrient disposal may help normalize leptin and ghrelin and improve body weight regulation. Design, Setting, and Participants: Ten young women with T1DM were studied in this 2-wk prospective, balanced crossover-design study at the University of California, Davis. Intervention: Participants received either a single injection of regular + NPH insulin (R+N) or two mealtime injections of Lispro insulin in randomized order on 2 separate days. Meal composition and total insulin administered were the same on both treatment days. Main Outcome Measures: Plasma glucose, insulin, leptin, and ghrelin concentrations were monitored over the 10-h study period. Results: Lispro produced two distinct mealtime peaks of insulin, compared with one prolonged rise with R+N. Lispro reduced postprandial hyperglycemia and total glucose area under the curve. Leptin increased more on the Lispro (2.7 ± 0.7 vs. 0.7 ± 0.5 ng/ml, P = 0.02). Ghrelin was more suppressed after lunch with Lispro (P = 0.004). Conclusions: Injection of Lispro insulin with meals produces more physiological insulin patterns, better glucose control, and improved leptin and ghrelin regulation than R+N. More closely mimicking normal insulin, leptin, and ghrelin responses to meals with fast-acting insulin may have implications for body weight regulation in T1DM.

AB - Context: Overweight and obesity are overrepresented in adolescents with type 1 diabetes mellitus (T1DM). Exogenous insulin administration often poorly reproduces normal insulin patterns and may less effectively regulate leptin and ghrelin, two hormones involved in the control of appetite and adiposity. Objective: The objective of the study was to determine whether insulin regimens that better replicate normal insulin patterns and augment postprandial nutrient disposal may help normalize leptin and ghrelin and improve body weight regulation. Design, Setting, and Participants: Ten young women with T1DM were studied in this 2-wk prospective, balanced crossover-design study at the University of California, Davis. Intervention: Participants received either a single injection of regular + NPH insulin (R+N) or two mealtime injections of Lispro insulin in randomized order on 2 separate days. Meal composition and total insulin administered were the same on both treatment days. Main Outcome Measures: Plasma glucose, insulin, leptin, and ghrelin concentrations were monitored over the 10-h study period. Results: Lispro produced two distinct mealtime peaks of insulin, compared with one prolonged rise with R+N. Lispro reduced postprandial hyperglycemia and total glucose area under the curve. Leptin increased more on the Lispro (2.7 ± 0.7 vs. 0.7 ± 0.5 ng/ml, P = 0.02). Ghrelin was more suppressed after lunch with Lispro (P = 0.004). Conclusions: Injection of Lispro insulin with meals produces more physiological insulin patterns, better glucose control, and improved leptin and ghrelin regulation than R+N. More closely mimicking normal insulin, leptin, and ghrelin responses to meals with fast-acting insulin may have implications for body weight regulation in T1DM.

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