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The effect of improved post-prandial blood glucose control on post-prandial metabolism and markers of vascular risk in people with Type 2 diabetes

Lookup NU author(s): Emeritus Professor Philip Home


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A variety of abnormalities of metabolic, haemostatic and endothelial markers are associated with Type 2 diabetes. Evidence suggests that poor post-prandial blood glucose control may contribute to vascular risk. We aimed to examine whether the restoration of a more physiological insulin profile post-prandially would improve these abnormalities. Twenty-one patients with insulin-treated Type 2 diabetes were recruited into a single centre, crossover, double-blind study. Patients were randomized to unmodified human insulin or insulin aspart before main meals for 6-week study periods, both together with NPH insulin. At the end of each study period, pre-breakfast levels of markers of vascular risk were assessed and a test meal performed. There was no significant difference in HbA1c (7.04 ± 0.13% (±S.E.) versus 7.15 ± 0.11%, P = 0.060) with insulin aspart compared to human insulin at the end of each study period. The mean post-prandial blood glucose concentration at 90 min from self-monitored results was lower with insulin aspart than with human insulin (7.9 ± 0.4 mmol/l versus 9.3 ± 0.4 mmol/l, P = 0.011) as was study day post-prandial blood glucose at 90 min (8.4 ± 0.5 mmol/l versus 9.2 ± 0.6 mmol/l, P = 0.046). No significant differences were found in fasting lipid profile, apolipoproteins, fibrinogen, plasminogen activator inhibitor-1, E-selectin, or homocysteine between the two study periods. Insulin aspart resulted in improved post-prandial glycaemic control when compared to human insulin in Type 2 diabetic patients, but this was not associated with changes in markers of vascular risk. © 2004 Elsevier Ireland Ltd. All rights reserved.

Publication metadata

Author(s): Gallagher A, Home PD

Publication type: Article

Publication status: Published

Journal: Diabetes Research and Clinical Practice

Year: 2005

Volume: 67

Issue: 3

Pages: 196-203

Print publication date: 01/03/2005

ISSN (print): 0168-8227

ISSN (electronic): 1872-8227

Publisher: Elsevier


DOI: 10.1016/j.diabres.2004.07.010

PubMed id: 15713351


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