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Acceleration of insulin pharmacodynamic profile by a novel insulin infusion site warming device.
Cengiz, Eda; Weinzimer, Stuart A; Sherr, Jennifer L; Tichy, Eileen; Martin, Melody; Carria, Lori; Steffen, Amy; Tamborlane, William V.
Afiliación
  • Cengiz E; Division of Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT 06520, USA. Eda.Cengiz@yale.edu
Pediatr Diabetes ; 14(3): 168-73, 2013 May.
Article en En | MEDLINE | ID: mdl-23107353
BACKGROUND AND OBJECTIVE: Subcutaneously injected rapid-acting insulin analogs do not replicate physiologic insulin action due to delays in their onset and peak action resulting in postprandial glucose excursions. The InsuPatch (IP) is a novel insulin infusion site warming device developed to accelerate insulin action by increasing blood flow to the area of insulin absorption. Thirteen adolescents with type 1 diabetes (T1D, mean age 14 ± 4 yr) were enrolled in this study to investigate the effect of the IP on the pharmacodynamics and pharmacokinetics of a 0.2 unit/kg bolus dose of aspart insulin using the euglycemic clamp technique. RESEARCH DESIGN AND METHODS: Each subject underwent two euglycemic clamp procedures on separate occasions: one with IP and one without IP activation in random order. RESULTS: When the insulin bolus was given with IP activation as compared to without IP activation, time to reach maximum insulin action (T(GIRmax)) and to reach 50% maximum action (T(50%GIRmax)) were 35 and 18 min earlier (125 ± 8 min vs. 90 ± 6 min, p = 0.002 and 58 ± 5 min. vs. 40 ± 3 min, p = 0.01, respectively), and the area under curve, AUC(GIR 0-90 min), reflecting early glucodynamic action, was significantly greater (p = 0.001). IP activation also accelerated the rise in plasma insulin levels after the bolus (p = 0.03) and resulted in a higher peak (p = 0.04) and greater overall increase (p = 0.02) in plasma insulin levels. CONCLUSIONS: Our results show that insulin infusion site warming with IP activation accelerates the time action profile of aspart insulin which may be of benefit to current open-loop and future closed-loop insulin delivery in patients with T1D.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Flujo Sanguíneo Regional / Sistemas de Infusión de Insulina / Diabetes Mellitus Tipo 1 / Insulina Aspart / Hipoglucemiantes Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Pediatr Diabetes Asunto de la revista: ENDOCRINOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Flujo Sanguíneo Regional / Sistemas de Infusión de Insulina / Diabetes Mellitus Tipo 1 / Insulina Aspart / Hipoglucemiantes Tipo de estudio: Clinical_trials Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Pediatr Diabetes Asunto de la revista: ENDOCRINOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Dinamarca