Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus

Aims The long duration of action of soluble insulin given in the evening could contribute to the high prevalence of nocturnal hypoglycaemia seen in young children with Type 1 diabetes mellitus (T1DM). We examined whether replacing soluble insulin with insulin lispro reduced this risk in children on...

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Bibliographic Details
Published in:Diabetic medicine 2003-08, Vol.20 (8), p.656-660
Main Authors: Ford-Adams, M. E., Murphy, N. P., Moore, E. J., Edge, J. A., Ong, K. L., Watts, A. P., Acerini, C. L., Dunger, D. B.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Glucose - analysis
Child
children
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - drug therapy
Diabetes. Impaired glucose tolerance
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Glycated Hemoglobin A - analysis
Humans
Hypoglycemia - prevention & control
Hypoglycemic Agents - therapeutic use
Insulin - analogs & derivatives
Insulin - therapeutic use
Insulin Lispro
Medical Records
Medical sciences
nocturnal hypoglycaemia
Risk Factors
Type 1 diabetes
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Summary:Aims The long duration of action of soluble insulin given in the evening could contribute to the high prevalence of nocturnal hypoglycaemia seen in young children with Type 1 diabetes mellitus (T1DM). We examined whether replacing soluble insulin with insulin lispro reduced this risk in children on a three times daily insulin regimen. Methods Open crossover study comparing insulin lispro vs. soluble insulin in 23 (16 boys) prepubertal children (age 7–11 years) with T1DM on three injections/day; long‐acting isophane insulin remained identical. At the end of each 4‐month treatment arm, an overnight 15‐min venous sampled blood glucose profile was performed. Results Despite similar blood glucose levels pre‐evening meal (lispro vs. soluble: mean ± se 6.5 ± 1.0 vs. 7.1 ± 1.1 mmol/l, P = 0.5), post‐meal (18.00–22.00 h) blood glucose levels were lower on insulin lispro (area under curve 138 ± 12 vs. 170 ± 13 mmol min−1 l−1, P = 0.03). In contrast, in the early night (22.00–04.00 h) the prevalence of low blood glucose levels (
ISSN:0742-3071
1464-5491
DOI:10.1046/j.1464-5491.2003.01013.x