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Pediatr Diabetes. 2013 May;14(3):168-73. doi: 10.1111/pedi.12001. Epub 2012 Oct 28.

Acceleration of insulin pharmacodynamic profile by a novel insulin infusion site warming device.

Author information

  • 1Division of Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT 06520, USA. Eda.Cengiz@yale.edu

Abstract

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.

© 2012 John Wiley & Sons A/S.

PMID:
23107353
[PubMed - indexed for MEDLINE]
PMCID:
PMC3572265
Free PMC Article
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