Pharmacokinetics and pharmacodynamics of lispro-insulin in hemodialysis patients with diabetes mellitus
| Autor: | D. Czock, U. Aisenpreis, F.M. Rasche, P.M. Jehle |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Blood Glucose
medicine.medical_specialty endocrine system diseases Metabolic Clearance Rate medicine.medical_treatment Subcutaneous injection Renal Dialysis Internal medicine Diabetes mellitus medicine Insulin lispro Humans Hypoglycemic Agents Insulin Pharmacology (medical) Pharmacology Volume of distribution Insulin Lispro business.industry digestive oral and skin physiology Area under the curve Middle Aged medicine.disease Endocrinology Diabetes Mellitus Type 1 Pharmacodynamics Area Under Curve Regular insulin Kidney Failure Chronic business medicine.drug Half-Life |
| Zdroj: | International journal of clinical pharmacology and therapeutics. 41(10) |
| ISSN: | 0946-1965 |
| Popis: | Objective: Lispro-insulin, after subcutaneous injection in patients with normal renal function, is absorbed faster and has a faster onset of action when compared to regular insulin. However, the pharmacokinetics and pharmacodynamics of lispro-insulin in renal failure have not yet been investigated. Patients and methods: Eight patients with diabetes mellitus on long-term hemodialysis received an individualized dose of regular insulin or lispro-insulin in a crossover design. Blood glucose and insulin concentrations were measured before and after the subcutaneous insulin injections. Results: Plasma insulin concentrations increased faster (time of maximum concentration t max 20 vs 40 minutes, p = 0.01) and were higher (standardized maximum concentration C max / D 13.6 vs 6.1 μU/ml/U, p = 0.01) after lispro-insulin compared to regular insulin. The area under the curve, clearance and parameters of the hypoglycemic action for the 2 insulin products did not differ significantly, but there was a trend to minimum blood glucose level (time of the blood glucose minimum, Gt min ) to occur earlier with lispro-insulin (120 vs 210 minutes, p > 0.05). Differences in elimination half-life and volume of distribution were explained by flip-flop pharmacokinetics in the case of regular insulin. Conclusions: In hemodialysis patients with diabetes mellitus, lispro-insulin is absorbed faster than regular insulin. Differences in the effects of lispro-and regular insulin can be explained by the differences in pharmacokinetics. |
| Databáze: | OpenAIRE |
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