A comparison of the pharmacodynamic profiles of insulin detemir and insulin glargine: A single dose clamp study in people with type 2 diabetes

Abstract

AimThe pharmacodynamic properties of a single dose of 0.5U/kg insulin detemir and insulin glargine were compared during two 24-h isoglycaemic clamps, one week apart. MethodsThe order of treatments was randomised. At approximately 0830h, persons with T2DM received subcutaneous administration of a 0.5U/kg dose of either insulin detemir or insulin glargine into the anterior abdominal wall. Plasma glucose was measured at 10-min intervals throughout the 24-h clamp period and isoglycaemia was maintained by variable infusion of 20% glucose. Glucose infusion rates (GIR) and plasma C-peptide were determined throughout each 24-h period. ResultsEleven persons with type 2 diabetes (8 male) with mean (SD) age 58.5years (8.5), BMI 30.8kg/m2 (2.8) and HbA1c 7.5% (0.6) were studied. Plasma glucose remained constant during the clamp (CV: insulin detemir 3.7%; insulin glargine 3.8%). Following injection of insulin detemir, GIR increased, reaching a mean peak of 2.29mg/kg/min (95% CI 1.64, 2.94) at 11.6h (range 8.9 to 14.3) compared to 1.71mg/kg/min (95% CI 1.4, 2.0) at 10.2h (8.1 to 12.3) for insulin glargine (P=0.025 for GIRmax). Plasma C-peptide decreased during the study period, remaining significantly lower than the fasting level at the study end after both analogues, insulin detemir (P=0.01) and insulin glargine (P=0.02). ConclusionIn persons with T2DM, no difference in duration of action following a single subcutaneous dose of insulin detemir and insulin glargine could be observed. Insulin detemir showed greater between subject variability and achieved a significantly higher maximum GIR than insulin glargine.