The pharmacokinetics of s.c. Semitard MC, human NPH ge, Rapitard MC and human NPH 30:70 ge insulin in healthy, non-diabetic subjects.
BACKGROUND: Plasma glucose and insulin responses to Semitard MC versus human NPH ge and Rapitard MC versus human NPH 30:70 ge were examined in fasted healthy, non-diabetic subjects. METHODS: Twelve male subjects with a mean (+/-S.D.) age of 33.9+/-11.1 years and a BMI of 24.9+/-2.9 kg/m(2) were each involved on four separate study days 1 week apart. After fasting samples were taken, 0.2 U/kg of the allocated insulin preparation was injected subcutaneously (s.c.) as a bolus into the anterior abdominal wall. Blood samples were taken over the next 24 h. RESULTS: Subcutaneous injection of Semitard MC caused a greater fall in plasma glucose concentration and lower mean plasma glucose levels throughout the study compared to NPH, reflecting the higher insulin concentrations observed during the 24-h study period. Following s.c. Rapitard MC the plasma glucose levels were consistently higher than those achieved with human NPH 30:70 ge as a result of the lower concentrations of insulin with Rapitard MC insulin. CONCLUSIONS: To obtain the same level of glycaemic control, transferring patients from Semitard MC to human NPH may require a dose increase of 30% in the first instance to be adjusted upwards as deemed necessary. Transferring patients from Rapitard MC to human NPH 30:70 ge, a dose reduction of 25% may be required. Frequent home blood glucose monitoring should be carried out.