Can a particular insulin help achieve less variable blood glucose levels?

This study compared the effects of insulin lispro protamine (Humalog), glargine (Lantus) and detemir (Levemir) on blood glucose (sugar) levels in type 1 diabetics. 

There are many types of insulin available. They can be classified as rapid-acting, short-acting or long-acting. Rapid-acting insulin has a rapid onset and lasts for 4 hours. Short-acting insulin lasts for 8 hours and long-acting insulin lasts for 24 hours. Insulin lispro is a rapid-acting insulin, while glargine and detemir are both long-acting insulins. However, using insulin can result in variation in blood glucose levels and patients therefore have a greater risk of having a hypoglycaemic episode (severely low blood glucose levels) when blood glucose levels fluctuate. It’s not known which type of insulin gives rise to less variation of blood glucose levels.

This study aimed to determine the effects of lispro protamine, glargine and detemir on blood glucose levels. This study involved 49 type 1 diabetis (T1D) patients. Participants took insulin lispro 3 times daily and then either lispro protamine, glargine or detemir in the evening. Blood glucose levels were monitored for 2 months using a continuous glucose monitor (device worn by patients to measure blood glucose levels in real-time).

Blood glucose levels were in the target range of 3-10 mmol/L more often when lispro protamine and glargine were used in comparison to detemir. Blood glucose levels were less variable when lispro protamine (average 8 mmol/L) and glargine (average 8.3 mmol/L) were used in comparison to detemir (average 8.8 mmol/L). Night time hypoglycemia occurred less often when lispro protamine was used in comparison to glargine and detemir.   

This study concluded that there is less variability in blood glucose levels when patients used lispro protamine and glargine compared to detemir. Lispro protamine led to fewer episodes of hypoglycemia. 

A small sample size of 49 participants was used.