Lipid changes during basal insulin peglispro, insulin glargine, or NPH treatment in six IMAGINE trials

Diabetes Obes Metab. 2016 Nov;18(11):1089-1092. doi: 10.1111/dom.12754. Epub 2016 Sep 14.

Abstract

Basal insulin peglispro (BIL) is a novel basal insulin with hepato-preferential action resulting from reduced peripheral effects. This report provides an integrated summary of lipid changes at 26 weeks with BIL and comparator insulins (glargine, NPH) from phase III studies in type 1 diabetes (T1D), insulin-naïve patients with type 2 diabetes (T2D), patients with T2D on basal insulin only and patients with T2D on basal-bolus therapy. BIL treatment had little effect on HDL cholesterol and LDL cholesterol in all patients. The effect of both BIL and glargine treatment on triglycerides (TG) depended on whether patients had been previously treated with insulin. When BIL replaced conventional insulin glargine or NPH treatments, increases in TG levels were observed. When BIL or comparator insulins were given for 26 weeks to insulin-naïve patients with T2D, TG levels were unchanged from baseline with BIL but decreased with either glargine or NPH. The decreased peripheral action of BIL may reduce suppression of lipolysis in peripheral adipose tissue resulting in increased free fatty acid delivery to the liver and, hence, increased hepatic TG synthesis and secretion.

Keywords: NPH; basal insulin peglispro; dyslipidaemia; insulin glargine; triglycerides.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / pharmacology*
  • Insulin Glargine / administration & dosage
  • Insulin Glargine / pharmacology*
  • Insulin Lispro / administration & dosage
  • Insulin Lispro / analogs & derivatives*
  • Insulin Lispro / pharmacology
  • Insulin, Isophane / administration & dosage
  • Insulin, Isophane / pharmacology*
  • Lipid Metabolism / drug effects*
  • Lipids / blood*
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / pharmacology*
  • Retrospective Studies
  • Triglycerides / blood*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin Lispro
  • Lipids
  • Triglycerides
  • basal insulin peglispro
  • Insulin Glargine
  • Polyethylene Glycols
  • Insulin, Isophane