PMID- 17705693
OWN - NLM
STAT- MEDLINE
DCOM- 20071113
LR  - 20221207
IS  - 1520-9156 (Print)
IS  - 1520-9156 (Linking)
VI  - 9
IP  - 4
DP  - 2007 Aug
TI  - Comparison of oral insulin spray and subcutaneous regular insulin at mealtime in 
      type 1 diabetes.
PG  - 372-6
AB  - BACKGROUND: The aim of this study was to compare the glucose pharmacodynamics 
      after oral spray insulin (Oral-lyn , Generex Biotechnology, Toronto, ON, Canada) 
      and subcutaneous (sc) injection of regular insulin in 10 subjects with type 1 
      diabetes mellitus (T1DM). METHODS: Basal therapy was twice-daily insulin 
      glargine. Preprandial (30 min) regular insulin was given for 3 days, followed by 
      9 days of Oral-lyn, eight to 12 puffs immediately pre- and postprandially. 
      Adjustments for glycemia were made using standard snacks and additional regular 
      insulin or Oral-lyn. Peripheral glucose measurements were self-monitored in 
      duplicate. Serum concentrations of fructosamine and hemoglobin A1c (HbA1c) were 
      determined at the start and the end of the study period. RESULTS: Average glucose 
      concentrations (in mmol/L) for the 3-day regular insulin and 9-day Oral-lyn 
      periods, respectively, were: pre-breakfast (B), 5.06 and 3.89; 1-h post-B, 8.39 
      and 7.67; post-B, 6.00 and 6.33; pre-lunch (L), 5.50 and 4.72; 1-h post-L, 7.83 
      and 7.89; 2-h post-L, 5.89 and 6.33; pre-dinner (D), 5.61 and 5.17; 1-h post-D, 
      7.22 and 7.83; and 2-h post-D, 6.11 and 6.67. Areas under the curve for both 
      treatments were not significantly different (P = 0.6875). Fructosamine (mean +/- 
      SD, 338.7 +/- 77.4 micromol/L and 321.7 +/- 63.4 micromol/L), and HbA1c (mean +/- 
      SD, 7.5 +/- 1.5% and 7.2 +/- 1.2%) did not change significantly. CONCLUSIONS: 
      Regular insulin and Oral-lyn had similar glucodynamic effects in subjects with 
      T1DM receiving twice-daily insulin analogue as baseline therapy. Intensive 
      monitoring and timely corrections with additional snacks, additional sc regular 
      insulin, or Oral-lyn puffs resulted in appropriate glycemic control as assessed 
      by individual daily glycemic responses and, especially, normal preprandial 
      glycemia. Protein glycation decreased, but not significantly.
FAU - Guevara-Aguirre, Jaime
AU  - Guevara-Aguirre J
AD  - Institute for Endocrinology Metabolism and Reproduction, Quito, Ecuador. 
      jguevara@iemyr-ecuador.org
FAU - Guevara-Aguirre, Marco
AU  - Guevara-Aguirre M
FAU - Saavedra, Jeannette
AU  - Saavedra J
FAU - Bernstein, Gerald
AU  - Bernstein G
FAU - Rosenbloom, Arlan L
AU  - Rosenbloom AL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Long-Acting)
RN  - 2ZM8CX04RZ (Insulin Glargine)
SB  - IM
MH  - *Administration, Oral
MH  - Adolescent
MH  - Adult
MH  - Blood Glucose/drug effects/*metabolism
MH  - Blood Glucose Self-Monitoring
MH  - Body Mass Index
MH  - Diabetes Mellitus, Type 1/*blood/drug therapy
MH  - Eating
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/administration & dosage/therapeutic use
MH  - Injections, Subcutaneous
MH  - Insulin/administration & dosage/*analogs & derivatives/*therapeutic use
MH  - Insulin Glargine
MH  - Insulin, Long-Acting
MH  - Male
EDAT- 2007/08/21 09:00
MHDA- 2007/11/14 09:00
CRDT- 2007/08/21 09:00
PHST- 2007/08/21 09:00 [pubmed]
PHST- 2007/11/14 09:00 [medline]
PHST- 2007/08/21 09:00 [entrez]
AID - 10.1089/dia.2006.0019 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2007 Aug;9(4):372-6. doi: 10.1089/dia.2006.0019.