Research Article: A non-inferiority study to compare daily fast-acting insulin versus twice a week slow-acting insulin–moderate diabetes mode1

Date Published: August 05, 2020

Publisher: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia

Author(s): Cristina Pires Camargo, Rafael Hori Nagamine Weschenfelder, Guilherme Moreira da Fonseca, Alexandre Agostinho da Cruz Sousa, Rolf Gemperli.


Given the high prevalence of diabetes (D), several animal models have been analyzed. In the literature, most of the animal models have studied severe D. However, in clinical practice, most patients have moderate disease. Therefore, the present study aimed to describe a moderate D condition.

We analyzed 20 Wistar rats, age eight-weeks, weight between 200g-250g. All animals received an intravenous injection of Streptozotocin (55mg/kg weight). On the 15th day after D induction, the animals were divided into two groups: Group I – animals receiving a single daily dose of fast-acting insulin (FAIG) NPH (1UI,SC) for partial glycemic control, and Group II – animals receiving slow-acting insulin(SAIG) twice a week. We measured glycemia, weight, and adverse events every week during two months.

Of the total of animals analyzed in the study, three animals died in the FAIG and two animals died in the SAIG. Regarding the glycemic level, results were 339.5 ± 125.4mg/dL (95CI 302.3402 to 376.6842) in the FAIG, and 367.8 ± 66.1mg/dL (95IC 333.7607 to 401.8978) in the SAIG. There was no difference between groups as to weight during the study.

The use of slow-acting-insulin is not inferior to the use of fast-acting-insulin in the management of partially insulin-controlled moderate diabetes in rats.

Partial Text

Diabetes has a high prevalence in the world population. In Brazil, the prevalence of diabetes is around 12%1.

This study was approved by CEUA (66/15) and followed CONCEA guidelines.

Twenty-four hours after the Streptozotocin (STZ) injection all animals became diabetic (blood glucose> 200mg/dL). After a six-week period, 100% of the animals remained diabetic and study measurements began.

Our study showed that using slow-acting insulin is not inferior to fast-acting insulin for partially controlling glycemia in diabetic rats induced by streptozotocin. This finding is relevant to create an experimental model of partially controlled chronic diabetes, because of the high prevalence of individuals with moderate diabetes in our daily clinical practice6,8. According to literature data, there are several animal models to induce diabetes.

Using slow-acting insulin is not inferior to using fast-acting insulin in the maintenance of partially insulin-controlled moderate diabetes in rats.




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