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Research Article
Volume 6 Issue 1 - 2021
Impact of Short-Acting Insulin Analogs on Biomarkers of Oxidative Stress and Chronic Systemic Inflammation in Patients with Type 2 Diabetes - Results from a Pilot Study for Hypothesis Generation
Andreas Pfützner1-3*, Sachsenheimer D1, Pfützner AH1, Demircik F1 and Forst T4
1Pfützner Science and Health Institute, Diabetes Center and Practice, Mainz, Germany
2University for Digital Technologies in Medicine and Dentistry, Wiltz, Luxembourg
3Technical University, Bingen, Germany
4CRS Clinical Research Services Mannheim GmbH. Mannheim, Germany
*Corresponding Author: Andreas Pfützner, Pfützner Science and Health Institute, Diabetes Center and Practice, Mainz, Germany.
Received: November 20, 2020; Published: December 11, 2020




Abstract

Primary objective of this pilot study was to collect data for hypothesis generation regarding the impact of short-acting insulin analogs (insulin aspart/IA and insulin glulisine/IG in comparison to regular human insulin/RHI) on biomarkers of inflammation and oxidative stress in patients with type 2 diabetes. Twelve patients on basal insulin and oral drug treatment (11 male, age: 64 ± 9 yrs., HbA1c: 7.1 ± 0.6%, BMI: 31.5 ± 4.9 kg/m2) were randomized to intensive insulin therapy with insulin glargine and either IA, IG, or RHI. An OGGT was performed at baseline and after six months with assessment of nitrotyrosine, hsCRP, microcirculation (laser doppler) and mRNA macrophage activation markers (IL6, TNFalpha, eNOS, MAPK) after 0/1/2h. Reduction of HbA1c to near normal levels, and similar glucose excursions and microcirculation results were seen in all three groups. At endpoint, reductions in nitrotyrosine were observed with both analogs (-33 %) but not with RHI (+31 %, p < 0.05 vs. the combined analogs. IL-6 expression decreased with IG (-5 %) but increased with IA (+142%) and RHI (+64 %). TNFalpha expression decreased in all three groups (IG: -35%, IA: -71%, RHI: -30%). Vasoprotective eNOS expression increased with IG (+25 %) and decreased with IA (-28 %; RHI: +1 %). MAPK1- expression was reduced in all three groups (-16%, -23%, -33%). hsCRP was reduced by -78 % with IG only (IA: -2%, RHI: - 11%, p < 0.05 vs. IG in both groups). In this pilot study, improvement of the inflammatory vascular situation could be observed consistently with IG, partly with IA and barely with RHI.

Keywords: Insulin Analogs; Biomarkers; Oxidative Stress; Chronic Systemic Inflammation; Type 2 Diabetes

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Citation: Andreas Pfützner., et al. “Impact of Short-Acting Insulin Analogs on Biomarkers of Oxidative Stress and Chronic Systemic Inflammation in Patients with Type 2 Diabetes - Results from a Pilot Study for Hypothesis Generation”. EC Endocrinology and Metabolic Research 6.1 (2021): 10-17.

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