We sought to investigate the ability of
biphasic insulin aspart 30 (
BIAsp 30) to control
postprandial hyperglycemia and
hyperlipidemia in a meal-test comparison with
biphasic human insulin 30 (
BHI 30). In this randomised crossover trial, 50 patients with
type 1 diabetes (mean age, 35.7 +/- 9.4 years; body mass index [BMI], 24.0 +/- 2.6 kg/m(2); HbA(1c), 8.6% +/- 1.1%) were studied on 3 separate days, where the following treatments were given in random order:
BIAsp 30 injected immediately before a standard breakfast,
BHI 30 injected 30 minutes before breakfast (
BHI 30(t=-30)), and
BHI 30 injected immediately before breakfast (
BHI 30(t=0)). The dose was 0.40 U/kg for all 3 treatments.
BIAsp 30 reduced the area under the baseline adjusted 4-hour postprandial serum
glucose curve (AUC(0-4h)) by 23% compared with
BHI 30(t=0) (P <.0001) and by 9% compared with
BHI 30(t=-30) (P =.013). Maximum serum
glucose concentration (C(max)) was lower for
BIAsp 30 compared with
BHI 30(t=0) (14.0 +/- 2.4 v 16.5 +/- 2.8 mmol/L, P <.0001), and time to maximal serum
glucose concentration (t(max)) was approximately 20 minutes shorter for
BIAsp 30, irrespective of timing of
BHI 30 injection (P <.0001). There were no significant differences among the 3 treatments with respect to postprandial levels of
free fatty acids or
triglycerides. The pharmacokinetic results were consistent with the above observations, ie, significantly larger
insulin AUC(0-4h), higher C(max) and shorter t(max) were observed for
BIAsp 30 compared with
BHI 30, irrespective of timing of
BHI 30 injection. We conclude that postprandial
glycemic control was more effective with
BIAsp 30 than with
BHI 30, irrespective of timing of
BHI 30 injection.