Effectiveness of Intensified Conventional Insulin Therapy Using Human Ultralente Insulin and the Pen System

Abstract

Intensified conventional insulin therapy using human ultralente insulin (U-HM) and human actrapid insulin (Novo pen system'I) was tried in 10 diabetic patients poorly controlled with conventional therapy.
1) Both fasting plasma glucose (211±27 vs. 125±12 mg/dl, p<0.01) and hemoglobin A1 (12.5±0.4 vs. 10.6±0.4%, p<0.01) levels decreased after about 2 months of intensified conventional insulin therapy.
2) With this regimen the circadian profile of free insulin concentraion became more physiological with an increase in free insulin level after each meal. Improvement of circadian variation of plasma glucose was also found.
3) There was a good correlation between the dose of U-HM and free insulin concentration at 3 a.m. (r=0.793, p<0.05) and between the dose of U-HM and basal infusion rate (0-8 a.m.) determined by an artificial pancreas (r=0.782, p<0.05).
These results indicate that intensified conventional insulin therapy using the pen system and U-HM may provide the proper amount of insulin both postprandial (by the pen system) and in the basal state (by U-HM) and be a useful method for the treatment of patients poorly controlled by conventional insulin therapy.