Optimal dose and timing of insulin Aspart to mimic first phase insulin response in patients with recently onset type 2 diabetes

ObjectiveTo assess the optimal dose and timing of subcutaneous injection of insulin Aspart (IAsp) in relation to meal to mimic first phase insulin response in patients with recently diagnosed type 2 diabetes.Design and methodsTwenty patients were randomised in a double blind, double dummy design to four standard meal tests with pre-meal injection of insulin Aspart 0.08 IU/kg BW 30 min before the meal, insulin Aspart 0.04 IU/kg BW 30 or 15 min before the meal and placebo.ResultsAll three insulin regimes significantly reduced postprandial glucose increment (area under the curve AUC−30 to 240 min) and peak plasma glucose increment (ΔCmax) compared with placebo. Postprandial glucose increment AUC−30 to 240 min but not ΔCmax was significantly lower with IAsp 0.08 IU/kg BW as compared to IAsp 0.04 IU/kg BW, (p < 0.03 and p = 0.18). One patient experienced hypoglycaemia after injection of IAsp 0.08 IU/kg BW. No difference in postprandial glucose profile was demonstrated whether IAsp 0.04 IU/kg BW was administrated 15 or 30 min before mealtime.ConclusionsIAsp 0.04 IU/kg BW injected subcutaneously 15 or 30 min before meal reduced the postprandial blood glucose increment without risk of hypoglycaemia in patients with recently diagnosed type 2 diabetes. Doubling of the IAsp dose significantly reduced the postprandial glucose increment but increased the risk of hypoglycaemia.