Defining the Role of Insulin Lispro in the Management of Postprandial Hyperglycaemia in Patients with Type 2 Diabetes Me
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REVIEW ARTICLE
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Defining the Role of Insulin Lispro in the Management of Postprandial Hyperglycaemia in Patients with Type 2 Diabetes Mellitus D. Giugliano,1 A. Ceriello,2,3 E. Razzoli4 and K. Esposito1 1 2 3 4
Department of Geriatrics and Metabolic Diseases, Metabolic Diseases Division, University of Naples SUN, Naples, Italy Warwick Medical School, University Hospital of Coventry and Warwickshire, University of Warwick, Coventry, UK INRCA Ancona, Diabetes Unit, Ancona, Italy Medical Division Eli Lilly Italia, SpA, Florence, Italy
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 1. Postprandial Hyperglycaemia and Cardiovascular Risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200 2. Importance of Tight Metabolic Control in Type 2 Diabetes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 202 3. Role of Insulin Lispro in Patients with Type 2 Diabetes not Responding Adequately to Oral Antihyperglycaemic Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 3.1 Efficacy of Insulin Lispro in Reducing Postprandial Hyperglycaemia in Type 2 Diabetes . . . . . . 205 3.2 Efficacy of Insulin Lispro Mixes (Insulin Lispro plus Insulin Lispro Protamine Suspension) . . . . . . . . 206 4. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 5. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Abstract
The role of postprandial hyperglycaemia in contributing to the risk of both micro- and macrovascular complications in patients with diabetes mellitus is being increasingly recognized. In type 2 diabetes, there is a progressive shift in the relative contributions of postprandial and fasting hyperglycaemia to the overall glycaemic control as the disease progresses. For patients with fairly good glycaemic control (glycosylated haemoglobin [HbA1c]
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