Acta Diabetologica

, Volume 50, Issue 4, pp 529–535

Comparison of human insulin and insulin analogues on hypoglycaemia and metabolic variability in type 1 diabetes using standardized measurements (HYPO score and Lability Index)

  • M. Pérez-Maraver
  • J. Caballero-Corchuelo
  • A. Boltana
  • R. Insa
  • J. Soler
  • E. Montanya
Original Article

DOI: 10.1007/s00592-011-0320-y

Cite this article as:
Pérez-Maraver, M., Caballero-Corchuelo, J., Boltana, A. et al. Acta Diabetol (2013) 50: 529. doi:10.1007/s00592-011-0320-y

Abstract

To evaluate whether treatment with insulin analogues is associated with a lower risk of hypoglycaemia (HYPO score) and less glycaemic variability (Lability Index) than treatment with human insulin in patients with type 1 diabetes. In a 6-month prospective, open-labelled trial, we randomized 47 patients treated with human insulin to receive treatment with human insulin (n = 21) or insulin analogues (n = 26). HYPO score, Lability Index (LI), and hypoglycaemic episode characteristics were assessed at baseline and at the end of follow-up. A 72-h, continuous glucose monitoring was performed at the end in a subgroup of patients. Groups were compared with nonparametric tests. Significance was defined as P < 0.05. HYPO score (71.5 [36.0–162] vs. 260 [52.0–676], P < 0.05), nocturnal hypoglycaemia (0.4 vs. 1.4 events/patient/4-week, P < 0.05), and <2.5 mmol/l hypoglycaemic events were lower in insulin analogue group after 6 months. There was a trend towards a lower LI in insulin analogue group (74.3 [51.3–133] vs. 123 [76.4–171] mmol/l2/h week−1, P = 0.064). HbA1c and insulin dose were comparable between groups. In type 1 diabetes, insulin analogues were associated with a lower hypoglycaemic risk and a trend towards reduced glycaemic variability compared with human insulin. These effects occurred despite comparable metabolic control.

Keywords

Insulin analoguesHypoglycaemiaHYPO scoreLability Index

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • M. Pérez-Maraver
    • 1
    • 3
    • 4
  • J. Caballero-Corchuelo
    • 1
    • 3
    • 4
  • A. Boltana
    • 1
  • R. Insa
    • 1
  • J. Soler
    • 1
    • 2
    • 3
    • 4
  • E. Montanya
    • 1
    • 2
    • 3
    • 4
  1. 1.Endocrine Unit (13-2), Hospital Universitari BellvitgeL’Hospitalet de Llobregat, BarcelonaSpain
  2. 2.Department of Clinical ScienceMedical School, University of BarcelonaBarcelonaSpain
  3. 3.Institut d′Investigació Biomèdica de Bellvitge (IDIBELL)L’Hospitalet de Llobregat, BarcelonaSpain
  4. 4.CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)BarcelonaSpain