Insulin lispro: experience in a private practice setting

To assess the benefits (or otherwise) of changing patients with unstable type 1 diabetes to insulin lispro (Humalog, Aza Research).

150 patients with type 1 diabetes treated in a private metropolitan physician practice.

Glycohaemoglobin (%HbA1c) value; frequency of hypoglycaemia; patients' perceptions of the two regimens.

125 of 150 patients completed the study; 12 (8%) withdrew because they were dissatisfied with lispro. Including these 12 patients, 80/137 patients (58%) felt better physically and 98 (72%) were more satisfied with treatment with lispro. Of the 125 patients who completed the study, 65 (52%) achieved lower HbA1c values, with 22 (18%) experiencing a fall of 1% or more; 78 patients (62%) noted less daytime hypoglycaemia and 103 (82%) experienced less nocturnal hypoglycaemia. Thirty-nine patients (31%) with less daytime hypoglycaemia and 52 (42%) with less nocturnal hypoglycaemia also experienced a fall of more than 0.2% in HbA1c value (mean, 1.0%; range, 0.3%-3.2%). There was no change in body weight or in hypoglycaemia unawareness.

Many patients with unstable type 1 diabetes, when changed to insulin lispro, experience significant clinical and biochemical benefits.