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Comparative effect of human soluble insulin and insulin aspart upon hypoglycaemia-induced alterations in cardiac

Robert T C E Robinson1, Nigel D Harris, Robert H Ireland

  • 1University of Sheffield, Clinical Sciences Centre, Northern General Hospital, Sheffield S5 7AU, UK.

British Journal of Clinical Pharmacology
|March 13, 2003
PubMed
Abstract

Insights

Sudden death in young diabetics may link to nocturnal hypoglycemia. Both human insulin and insulin aspart similarly affect cardiac repolarization, with insulin aspart showing less QT dispersion during hypoglycemia.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Sudden death in young diabetic patients is linked to nocturnal hypoglycemia and cardiac dysrhythmias.
  • Hypoglycemia can cause abnormal cardiac repolarization, potentially leading to fatal arrhythmias.

Purpose of the Study:

  • To compare the effects of soluble human insulin (HI) and insulin aspart (IAsp) on cardiac repolarization during hypoglycemia.
  • To investigate the impact of these insulins on QT dispersion and QTc intervals.

Main Methods:

  • 17 healthy males participated in hyperinsulinemic hypoglycemic clamp studies.
  • Blood glucose was lowered to 2.5 mm using either HI or IAsp.
  • Cardiac repolarization (QT dispersion, QTc) and counter-regulatory hormones were measured.

Main Results:

  • Both HI and IAsp lowered blood glucose similarly with comparable clearance rates.
  • QTc intervals increased similarly with both insulins during hypoglycemia.
  • QT dispersion was significantly less pronounced with IAsp compared to HI.

Conclusions:

  • Soluble human insulin and insulin aspart exhibit similar effects on hypoglycemia-induced cardiac repolarization changes.
  • The comparable sympathoadrenal response and potassium levels likely explain the similar cardiac effects.

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