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Thread: The alteration of aspart insulin pharmacodynamics when mixed with detemir insulin.

  1. #1

    Default The alteration of aspart insulin pharmacodynamics when mixed with detemir insulin.

    The alteration of aspart insulin pharmacodynamics when mixed with detemir insulin.

    Diabetes Care. 2012 Apr;35(4):690-2. Epub 2012 Feb 28.
    The alteration of aspart insulin pharmacodynamics when mixed with detemir insulin.
    Cengiz E, Swan KL, Tamborlane WV, Sherr JL, Martin M, Weinzimer SA.
    Source
    Corresponding author: Eda Cengiz,
    OBJECTIVE Mixing rapid acting insulin analogs with detemir insulin to minimize daily injections has been adopted as a common regimen, especially for some children with type 1 diabetes, despite the manufacturing company's caution against mixing these analogs in the same syringe. The effect of this practice on the pharmacodynamics (PD) of rapid-acting insulin has not been widely studied. This crossover, randomized study was undertaken to determine whether mixing aspart with detemir insulin has an adverse effect on the early glucodynamic action of rapid-acting insulin analog in humans. RESEARCH DESIGN AND METHODS Eight adolescents with type 1 diabetes (age 17.3 ? 0.6 years and A1C 7.3 ? 0.3%) had two euglycemic glucose clamps during which 0.2 units/kg aspart and 0.4 units/kg detemir insulin were injected either as a separate or single mixed injection in random order. RESULTS Mixing the two insulins diminished the peak and overall early aspart insulin action with significantly lower maximum glucose infusion rate (GIR(max) separate 6.1 ? 0.7 mg/kg/min vs. mix 4.5 ? 0.5 mg/kg/min; P = 0.03) values and the area under curve for GIR during the first 3 h of the insulin action study (separate 757 ? 105 mg/kg vs. mix 491 ? 66 mg/kg; P = 0.04). CONCLUSIONS These data demonstrate that mixing aspart with detemir insulin markedly lowers the early PD action of aspart and prolongs its time-action profile as compared with the separate injection of these analogs. These changes in insulin PD should be weighed against the added convenience of mixing when considering such unlicensed use of these insulins in youth with type 1 diabetes.

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    Too many science words, anyone care to translate?
    Debby, Mama to Molly, age 7, dx'ed 12/05/2011, Pumping Omnipod with Humalog
    most recent a1c (1/14): 7.4
    Dexcom start 03/04/14

    and Henry, born 9//18/2013!

  3. #3

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    Quote Originally Posted by Debdebdebby13 View Post
    Too many science words, anyone care to translate?
    My translation: don't mix long acting and short acting. It lessens the impact of the insulins when you mix them.

    ~Nancy~
    Homeschooling our way through high school, learning with them!
    19 year old son diagnosed T1 2/5/10, pumping Tslim beginning 7/13 ; Dexcom on occasion. Animas Ping 10/10-7/13. College student August 2013.
    16 year old daughter teaching her mom all about patience and grace
    .

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    Quote Originally Posted by nanhsot View Post
    My translation: don't mix long acting and short acting. It lessens the impact of the insulins when you mix them.
    Nice work on the translation!. Completely agree, combining novolog(novorapid) with levemir means the levemir doesn't last as long and the rapid insulin is no longer the same in terms of its action on glucose as it was when it wasn't mixed.

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