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December 15, 2003

Insulin Analogs, Insulin Pumps

Question from Wichita, Kansas, USA:

I'm a Pharmacist and was doing a continuing education program on new insulin delivery and technology. My husband is on a pump. The CE booklet had a section by Dr. Bruce Bode. In his last paragraph he said, "the best insulin for the pumps is insulin aspart" based on results of a study of his (Diabetes Care 2002; 25:439-444) in which symptomatic or confirmed hypoglycemia was reduced by 30% over insulin lispro and human insulin." I thought there was no real diffence between aspart and lispro. Is there new info that now suggests otherwise?

Answer:

The study you cite is Comparison of Insulin Aspart With Buffered Regular Insulin and Insulin Lispro in Continuous Subcutaneous Insulin Infusion. Regarding hypoglycemia, the study reports:
The rates of hypoglycemic episodes (blood glucose <50 mg/dl) per patient per month were similar (3.7, 4.8, and 4.4 for the IAsp, BR, and lispro groups, respectively). The study concludes by stating that insulin aspart is effective and well tolerated in users of insulin pumps. The study makes no claim that insulin aspart is superior to either lispro or buffered regular. JSH