LDL and apoB
CETP activity stays normal and unchanged with insulin lispro or regular insulin in type 1 diabetes (Metabolism 1998)
Original title: Effects of a short-acting insulin analog (Insulin Lispro) versus regular insulin on lipid metabolism in insulin-dependent diabetes mellitus
Ten patients with insulin-dependent diabetes mellitus were compared using preprandial insulin lispro versus regular insulin in an intensive insulin therapy protocol, with detailed lipoprotein composition and lipid transfer protein activity analysis. Total cholesterol and triglycerides were lower after regular insulin than after lispro, and the LDL to HDL ratio decreased significantly only after regular insulin (baseline 2.01, lispro 1.88, regular insulin 1.71, P < .05), while VLDL and IDL protein content showed differing patterns between the two treatments. Lipoprotein lipase and CETP activities were similar to a non-diabetic control group and did not change after either insulin regimen, whereas hepatic lipase activity was lower in diabetic patients than controls and remained lower after both treatments. The authors conclude that insulin lispro and regular insulin have only minor, likely non-relevant differences in their effects on lipoprotein metabolism in type 1 diabetes.
Original abstract
Insulin Lispro (IL) is a short-acting insulin analog that better reproduces the physiological postprandial insulin profile. The aim of this study was to compare the effects of intensive insulin therapy on lipid metabolism using preprandial IL and regular insulin (RI) in 10 insulin-dependent diabetes mellitus (IDDM) subjects. The mean hemoglobin A1c (HbA1c) at baseline was 7.13% +/- 1.2% and did not change after both treatments. In IDDM patients, total cholesterol and triglyceride levels appeared lower after RI than after IL. The low-density lipoprotein (LDL) to high-density lipoprotein (HDL) ratio significantly decreased only after RI (baseline, 2.01 +/- 0.6; IL, 1.88 +/- 0.6; RI, 1.71 +/- 0.5, P < .05). Although no very-low-density lipoprotein (VLDL) composition abnormalities were observed at baseline, the protein content was lower (P < .05) after IL (8.13% +/- 2.93%) than after RI (11.93% +/- 3.41%). Intermediate-density lipoprotein (IDL) protein depletion at baseline (6.14% +/- 6.84%) was normalized after both treatments (IL, 11.09% +/- 12.14%; RI, 10.38% +/- 16.68%, P < .05). LDL, HDL, HDL2, and HDL3 composition abnormalities were similar after both treatments and did not normalize. IDDM and control subjects showed similar LDL subfraction distribution at baseline and after both treatments. Two-hour postprandial VLDL composition alterations, although improved after RI, completely normalized after IL (P < .05). Lipoprotein lipase (LPL) and cholesteryl ester transfer protein (CETP) activities were similar to the control group and did not change after both treatments. Hepatic lipase (HL) activity was lower in diabetic patients (39.6 +/- 35.2 v 87.0 +/- 27.1 U/L, P < .01) and remained lower after both treatments. In conclusion, in IDDM patients, IL (injected immediately before the meal) may offer small different effects on lipoprotein metabolism versus RI (injected 30 minutes before the meal) that, taken together, do not seem relevant.
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.