Effect of Age of Infusion Site and Type of Rapid-Acting Analog on Pharmacodynamic Parameters of Insulin Boluses in Youth With Type 1 Diabetes Receiving Insulin Pump Therapy
Open accessAbstract
OBJECTIVE—The purpose of this study was to examine the effect of type of insulin analog and age of insertion site on the pharmacodynamic characteristics of a standard insulin bolus in youth with type 1 diabetes receiving insulin pump therapy. RESEARCH DESIGN AND METHODS—Seventeen insulin pump–treated adolescents with type 1 diabetes underwent two euglycemic clamp procedures after a 0.2 unit/kg bolus of either insulin aspart or lispro on day 1 and day 4 of insulin pump site insertion. The glucose infusion rate (GIR) required to maintain euglycemia was the primary pharmacodynamic measure. RESULTS—There were no statistically significant differences in any of the pharmacodynamic parameters between aspart and lispro during day 1 and day 4. However, when the two groups were combined, time to discontinuation of exogenous glucose infusion, and time to half-maximal onset and offset of insulin action were observed significantly earlier during day 4 compared with day 1 (P = 0.03–0.0004), but the overall area under the GIR curve was similar on day 1 and day 4. CONCLUSIONS—With both insulin aspart and lispro, there is an earlier peak and shorter duration of action with increasing duration of infusion site use, but overall insulin action is not affected.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The acute inflammatory response and the infusion of insulin may directly increase local blood flow, which may contribute to increased insulin uptake on day 5 of catheter wear-time.
“Furthermore, the acute inflammatory response and the infusion of insulin may directly increase local blood flow,33–38 which may contribute to increased insulin uptake on day 5 of catheter wear-time.”
From Detailed Analysis of Insulin Absorption Variability and the Tissue Response to Continuous Subcutaneous Insulin Infusion Catheter Implantation in Swine (2017) · cites this paper as [37]
The Conclusions propose that increased blood flow around an aging infusion site could explain earlier peak insulin action. They do not identify an acute inflammatory response or insulin infusion as the direct causes of that blood flow. The Methods and Results compare day 1 with day 4, not day 5; however, the day-5 uptake finding appears to be the citing authors’ application of the proposed mechanism, rather than a finding attributed to this source. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Mudaliar, S. R., Lindberg, F. A., Joyce, M., Beerdsen, P., Strange, P., Lin, A., & Henry, R. R. (1999) · Diabetes Care · doi:10.2337/diacare.22.9.1501 · Cited by 276 · see citing works
Flagged first, then by citations
Research works printed but not linked: 8
- [1]DCCT Research Group: The effects of intensive diabetes treatment on the development and progression of long-term complications in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial. N Engl J Med 329: 977–986, 1993 8366922
- [2]The DCCT Research Group: The effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial. J Pediatr 125: 177–188, 1994 8040759
- [3]DCCT/EDIC Research Group: Prolonged beneficial effects of intensive therapy of diabetes during adolescence: microvascular outcomes four years after conclusion of the Diabetes Control and Complications Trial. Pediatrics 139: 804–812, 2001 11743505
- [4]Zinman B, Tildesley H, Chiasson TJ, Tsue E, Strack T: Insulin lispro in CSII: results of a double-blind crossover study. Diabetes 46: 440–443, 1997 9032100
- [5]Howey DC, Bowsher RR, Brunelle RL, Woodworth JR: [Lys(B28), Pro(B29)] human insulin: a rapidly absorbed analogue of human insulin. Diabetes 43: 396–402, 1994 8314011
- [9]Danne T, Becker RHA, Heise T, Bittner C, Frick AD, Rave K: Pharmacokinetics, prandial glucose control, and safety of insulin glulisine in children and adolescents with type 1 diabetes. Diabetes Care 28: 2100–2105, 2005 16123473
- [10]Swan KL, Weinzimer SA, Steil G, Voskanyan G, Steffen A, Martin M, Tamborlane WV: Effect of puberty on the pharmacodynamic and pharmacokinetic properties of insulin pump therapy in youth with TIDM. Diabetes Care 31: 44–46, 2008 17909083
- [11]DeFronzo RA, Tobin JD, Andres R: Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol 237: E214–E223, 1979 382871
Cited by
Sorted by citations
Home, P. D. (2012) · Diabetes, Obesity and Metabolism · doi:10.1111/j.1463-1326.2012.01580.x · Cited by 212 · see citing works
Insulin Infusion Set: The Achilles Heel of Continuous Subcutaneous Insulin Infusion
Heinemann, L., & Krinelke, L. (2012) · Journal of Diabetes Science and Technology · doi:10.1177/193229681200600429 · Cited by 148 · see citing works
Heinemann, L. (2009) · Journal of Diabetes Science and Technology · doi:10.1177/193229680900300631 · Cited by 40 · see citing works
Hauzenberger, J. R., Hipszer, B. R., Loeum, C., McCue, P. A., DeStefano, M., Torjman, M. C., Kaner, M. T., Dinesen, A. R., Chervoneva, I., Pieber, T. R., et al. (2017) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2017.0175 · Cited by 39 · see citing works
- Authors
- Swan, K. L., Dziura, J. D., Steil, G. M., Voskanyan, G. R., Sikes, K. A., Steffen, A. T., Martin, M. L., Tamborlane, W. V., & Weinzimer, S. A.
- Affiliations
- Yale University (US)
- Boston Children's Hospital (US)
- Medtronic (United States) (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2009-02-01
- Volume
- 32
- Issue
- 2
- Pages
- 240-244
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC2628686
- OpenAlex
- W1973553754
- Cited by
- 82
- References
- 1
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 6 · 2015: 6 · 2014: 8 · 2013: 5 · 2012: 9
- FWCI
- 4.84
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- National Center for Research Resources (U54 RR023423)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Physical Sciences › Engineering › Biomedical Engineering › Intravenous Infusion Technology and Safety
- Keywords
- type 1 diabetes, insulin pump therapy, rapid-acting insulin analogs, insulin aspart, insulin lispro, bolus insulin, insulin pharmacodynamics, adolescents, euglycemic clamp, glucose infusion rate
- MeSH terms
- Adolescent, Blood Glucose, Child, Diabetes Mellitus, Type 1, Equipment Design, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Kinetics, Male, Glucose Clamp Technique, Patient Selection, Insulin Aspart, Insulin Lispro
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
