Metabolic and sympathovagal effects of bolus insulin glulisine versus basal insulin glargine therapy in people with type 2 diabetes: A randomized controlled study
| Autor: | Takehiro Kanamori, Takeo Tanaka, Hitomi Wakakuri, Yuki Kita, Toshinari Takamura, Yumie Takeshita |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
Male Insulin glulisine Sympathetic Nervous System Endocrinology Diabetes and Metabolism medicine.medical_treatment Insulin Glargine Type 2 diabetes 030204 cardiovascular system & hematology 0302 clinical medicine Insulin Glycemic variability Genetic Pleiotropy Fasting Articles General Medicine Middle Aged Clinical Trial Circadian Rhythm Treatment Outcome Clinical Science and Care Female medicine.drug Adult medicine.medical_specialty 030209 endocrinology & metabolism Glycemic Control Autonomic Nervous System Diseases of the endocrine glands. Clinical endocrinology 03 medical and health sciences Parasympathetic Nervous System Diabetes mellitus Internal medicine Internal Medicine medicine Humans Hypoglycemic Agents Aged Glycemic Autonomic nerve Sympathovagal effects Insulin glargine business.industry medicine.disease RC648-665 Endocrinology Diabetes Mellitus Type 2 Basal (medicine) Insulin therapy business |
| Zdroj: | Journal of Diabetes Investigation, Vol 12, Iss 7, Pp 1193-1201 (2021) Journal of Diabetes Investigation |
| ISSN: | 2040-1116 2040-1124 |
| Popis: | Aims/Introduction This study compares the effects of two different insulin regimens – basal versus bolus insulin – on metabolic and cardiovascular autonomic function in Japanese participants with type 2 diabetes. Materials and Methods Participants were randomly assigned to groups for therapy with insulin glulisine (IGlu) or insulin glargine (IGla). The primary efficacy end‐point was glycemic variability, including M‐values, mean of glucose levels, and a blood glucose profile of seven time points before and after the intervention. The secondary end‐points included pleiotropic effects, including endothelial and cardiac autonomic nerve functions. Results Blood glucose levels at all time points significantly decreased in both groups. Post‐lunch, post‐dinner, and bedtime blood glucose levels were significantly lower in the IGlu group than in the IGla group. Nadir fasting blood glucose levels at the end‐point were significantly lower in the IGla group than in the IGlu group. The M‐value and mean blood glucose levels were significantly decreased from baseline in both groups, although the former was significantly lower in the IGlu group than in the IGla group. IGla, but not IGlu, was found to elevate 24‐h parasympathetic tone, especially during night‐time, and it decreased 24‐h sympathetic nerve activity, especially at dawn. Conclusions Both IGlu and IGla regimens reduced glucose variability, with IGlu bringing a greater reduction in M‐value. IGla, but not IGlu, increased parasympathetic tone during night‐time and decreased sympathetic nerve activity at dawn. These findings shed light on the previously unrecognized role of night‐time basal insulin supplementation on sympathovagal activity in type 2 diabetes patients. Both insulin glulisine and insulin glargine regimens decrease glucose variability, with a greater decrease in M‐value by insulin glulisine in people with poorly controlled type 2 diabetes. Insulin glargine, but not insulin glulisine, elevated parasympathetic tone at night‐time, and reduced sympathetic nerve activity at dawn. |
| Databáze: | OpenAIRE |
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