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The effect of exercise on the absorption of inhaled human insulin in healthy volunteers

Petersen, AH ; Kohler, G ; Korsatko, S ; Wutte, A ; Wonisch, M ; Mautner, A ; Ronn, BB ; Clauson, P ; Laursen, T and Wollmer, Per LU , et al. (2008) In British Journal of Clinical Pharmacology 65(2). p.165-171
Abstract
What is already known about this subject * Exercise is known to affect absorption of other inhaled substances, but so far there are no reports on the effect of exercise on the absorption of inhaled insulin in humans. What this paper adds * This report is the first to investigate the effect of exercise on the absorption of inhaled insulin. * In this study in healthy volunteers we found that exercise early after dosing increased absorption (15-20%) of inhaled insulin over the first 2 h after start of exercise, with an approximately 30% increase in maximal insulin concentration, and unchanged overall absorption. Aims To investigate the effect of moderate exercise on the absorption of inhaled insulin. Methods A single-centre, randomized,... (More)
What is already known about this subject * Exercise is known to affect absorption of other inhaled substances, but so far there are no reports on the effect of exercise on the absorption of inhaled insulin in humans. What this paper adds * This report is the first to investigate the effect of exercise on the absorption of inhaled insulin. * In this study in healthy volunteers we found that exercise early after dosing increased absorption (15-20%) of inhaled insulin over the first 2 h after start of exercise, with an approximately 30% increase in maximal insulin concentration, and unchanged overall absorption. Aims To investigate the effect of moderate exercise on the absorption of inhaled insulin. Methods A single-centre, randomized, open-label, three-period cross-over trial was carried out in 12 nonsmoking healthy subjects. A dose of 3.5 mg inhaled human insulin was administered via a nebulizer and followed in random order by either 1) no exercise (NOEX), 2) 30 min exercise starting immediately after dosing (EX0), or 3) 30 min exercise starting 30 min after dosing (EX30). The study was carried out as a 10 h euglycaemic glucose clamp (90 mg dl(-1) (5.0 mmol l(-1))). Results The absorption of insulin over the first 2 h after start of exercise was 16% increased for EX0 (ratio (95%CI) 1.16 (1.04, 1.30), P = 0.01) and 20% increased for EX30 (1.20 (1.05, 1.36), P < 0.01), both compared with NOEX; the overall insulin absorption during 6 h and 10 h after dosing was not influenced by exercise. The maximum insulin concentration (C(max)) increased by 32% for EX0 and 35% for EX30 (both P < 0.01) compared with NOEX, while the time to C(max) was 31 min faster for EX0 (P < 0.01), but not significantly different after EX30, compared with NOEX. Conclusions A significant and clinically relevant increase of insulin absorption over the first 2 h after the beginning of exercise was observed. Until data from studies using the specific insulin inhalers exists, patients using inhaled insulin should be made aware of a potential increased absorption and higher concentration of insulin in connection with exercise. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Clinical Pharmacology
volume
65
issue
2
pages
165 - 171
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:17764475
  • wos:000252773800005
  • scopus:38649083108
  • pmid:17764475
ISSN
1365-2125
DOI
10.1111/j.1365-2125.2007.03000.x
language
English
LU publication?
yes
id
8b6b2e69-739a-46ee-98dd-0456c238497c (old id 1140738)
date added to LUP
2016-04-01 11:56:43
date last changed
2023-09-01 13:17:31
@article{8b6b2e69-739a-46ee-98dd-0456c238497c,
  abstract     = {{What is already known about this subject * Exercise is known to affect absorption of other inhaled substances, but so far there are no reports on the effect of exercise on the absorption of inhaled insulin in humans. What this paper adds * This report is the first to investigate the effect of exercise on the absorption of inhaled insulin. * In this study in healthy volunteers we found that exercise early after dosing increased absorption (15-20%) of inhaled insulin over the first 2 h after start of exercise, with an approximately 30% increase in maximal insulin concentration, and unchanged overall absorption. Aims To investigate the effect of moderate exercise on the absorption of inhaled insulin. Methods A single-centre, randomized, open-label, three-period cross-over trial was carried out in 12 nonsmoking healthy subjects. A dose of 3.5 mg inhaled human insulin was administered via a nebulizer and followed in random order by either 1) no exercise (NOEX), 2) 30 min exercise starting immediately after dosing (EX0), or 3) 30 min exercise starting 30 min after dosing (EX30). The study was carried out as a 10 h euglycaemic glucose clamp (90 mg dl(-1) (5.0 mmol l(-1))). Results The absorption of insulin over the first 2 h after start of exercise was 16% increased for EX0 (ratio (95%CI) 1.16 (1.04, 1.30), P = 0.01) and 20% increased for EX30 (1.20 (1.05, 1.36), P &lt; 0.01), both compared with NOEX; the overall insulin absorption during 6 h and 10 h after dosing was not influenced by exercise. The maximum insulin concentration (C(max)) increased by 32% for EX0 and 35% for EX30 (both P &lt; 0.01) compared with NOEX, while the time to C(max) was 31 min faster for EX0 (P &lt; 0.01), but not significantly different after EX30, compared with NOEX. Conclusions A significant and clinically relevant increase of insulin absorption over the first 2 h after the beginning of exercise was observed. Until data from studies using the specific insulin inhalers exists, patients using inhaled insulin should be made aware of a potential increased absorption and higher concentration of insulin in connection with exercise.}},
  author       = {{Petersen, AH and Kohler, G and Korsatko, S and Wutte, A and Wonisch, M and Mautner, A and Ronn, BB and Clauson, P and Laursen, T and Wollmer, Per and Pieber, TR}},
  issn         = {{1365-2125}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{165--171}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{British Journal of Clinical Pharmacology}},
  title        = {{The effect of exercise on the absorption of inhaled human insulin in healthy volunteers}},
  url          = {{http://dx.doi.org/10.1111/j.1365-2125.2007.03000.x}},
  doi          = {{10.1111/j.1365-2125.2007.03000.x}},
  volume       = {{65}},
  year         = {{2008}},
}