Local heating at the insulin injection site by the use of the InsuPad is able to reduce post-prandial glucose excursion in daily life

Professorship/Faculty: Clinical Psychology and Psychotherapy  
Authors: Hermanns, Norbert ; Kulzer, Bernhard ; Haak, Thomas
Corporate Body: EASD 48th Annual Meeting, 01.-05. Oktober 2012, Berlin, Germany
Publisher Information: Bamberg : OPUS
Year of publication: 2017
Pages / Size: 1 pdf-Datei (1 S.)
Source/Other editions: Ursprünglich in: Diabetologia : organ of the European Association for the Study of Diabetes 55 (2012) Supplement 1, S423; PS-1032
Year of first publication: 2012
Language(s): German
Licence: German Act on Copyright 
DOI: 10.1007/s00125-012-2688-9
URN: urn:nbn:de:bvb:473-opus4-486930
Document Type: Other
Background and aims: The insulin action profiles of subcutaneously injected
short acting insulin analogues are still slow compared to physiologically
released human insulin. Thus, postprandial glucose excursions cannot be
avoided. InsuPad is a medical device designed to accelerate insulin delivery
rate by applying local heat at the insulin injection site. Whenever an insulin
injection is given, the skin surface temperature is heated up locally to 38.5
C° for 30 minutes. This pilot-study examines the impact of the InsuPad use
on postprandial glucose excursions after breakfast and dinner in daily life
Materials and methods: Insulin resistant diabetic patients were instructed
to use the InsuPad when injecting bolus insulin prior to breakfast and dinner
for one month and to measure their blood glucose at least five times per day
(pre- and post-breakfast, pre-lunch and pre- and post-dinner). In the other
study phase patients were instructed to maintain the same blood glucose
measurement schedule for one month, without using the InsuPad. The order
of the study phases was randomized. All blood glucose data were transmitted
to a central computer using the DIASEND System. A valid pre-post-prandial
measurement time difference was 75 - 135 minutes. An ANOVA, controlling
for order of study phase, patient and meal (breakfast vs. dinner) was used to
analyze the effect of the InsuPad on postprandial glucose excursions. In this
study 10 diabetic patients took part (30% type 1 diabetes, age: 51.5 ±7.7 yrs.,
diabetes duration: 15.7 ± 7.7 yrs.; HbA1c: 8.2 ± 0.9%; bolus insulin dose: 51.7
± 22.2 insulin units per day; total insulin dose 0.92 insulin units per kg).
Results: Preprandial blood glucose levels were similar in the phase with (151.7
±46.8 mg/dl) and without the InsuPad (148.5 ±38.6 mg/dl, p=.385). Postprandial
glucose decreased by 0.05 ± 59.1 mg/dl, if InsuPad was used, whereas the
postprandial glucose levels increased by 11.3 ± 56.3 mg/dl if the InsuPad was
not used (p=.011). The number (283 vs. 257) and proportion of valid measurements
(65.5% vs. 64.4%, p=.740) in the phase with and without InsuPad
were highly comparable. The time differences between pre- and post-prandial
glucose measurements were very similar in both study phases (102.7 ±
19.0 vs. 102.3 ± 15.6 minutes with and without InsuPad, p=.777). The overall
glycaemic control (mean total blood glucose values) was significantly lower
when using the InsuPad compared to the no-use-phase (149.7 ± 54.5 mg/dl
vs. 158.7 ±57.7 mg/dl; p=.016). The percentage of hypoglycaemic (< 60 mg/dl)
or hyperglycaemic values (> 300 mg/dl) was slightly decreased when using the
InsuPad, but the difference was not statistically significant (% hypoglycaemic
values 1.5% vs. 1.8%, p=.496; % hyperglycaemic values 1.6% vs. 2.1%, p=.250).
Conclusion: This pilot-study indicates that local heating of the insulin injection
site in insulin resistant diabetic patients by using the InsuPad is able to reduce post-prandial blood glucose excursions as well as mean daily glucose
values significantly in daily life conditions. Safety parameters like the prevalence
of hypoglycaemic and hyperglycaemic glucose measurements were not
affected by the use of InsuPad.
Peer Reviewed: Ja
International Distribution: Ja
URI: https://fis.uni-bamberg.de/handle/uniba/41648
Release Date: 18. January 2017

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