Long term feasibility of multiple daily injections with insulin pens in children and adolescents with diabetes

During a period of 17 months, 15 C-peptide negative insulin-dependent diabetic children (14 +/- 4 years old) have used an injector pen (Novopen, Novo, France) to deliver soluble insulin before meals, in association with an insulin syringe for long-acting insulin administration at bedtime. Despite fr...

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Bibliographic Details
Published in:European journal of pediatrics 1989-11, Vol.149 (2), p.80-83
Main Authors: TUBIANA-RUFI, N, LEVY-MARCHAL, C, MUGNIER, E, CZERNICHOW, P
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Blood Glucose - analysis
Child
Consumer Behavior
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - drug therapy
Feasibility Studies
Female
General and cellular metabolism. Vitamins
Glycated Hemoglobin A - analysis
Humans
Injections - instrumentation
Insulin - administration & dosage
Male
Medical sciences
Pharmacology. Drug treatments
Syringes
Time Factors
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Summary:During a period of 17 months, 15 C-peptide negative insulin-dependent diabetic children (14 +/- 4 years old) have used an injector pen (Novopen, Novo, France) to deliver soluble insulin before meals, in association with an insulin syringe for long-acting insulin administration at bedtime. Despite frequent daily insulin injections (4-5) and blood glucose determinations (3-4), long-term patient acceptability as well as cutaneous tolerance were excellent. Novopen was experienced as a progress (100%) which made a multiple injection regimen acceptable and provided an improvement in the quality of life (77%), as recorded by questionnaires answered at the end of the study. Twelve out of 15 patients chose to continue this treatment. No significant change in glycaemic control was observed in the group as a whole. An improvement in glycosylated haemoglobin (HbA 1c) was noticed only in the previously "poorly-controlled" children (n = 8) with initial HbA1c greater than 7%. In this group HbA1c decreased from 8.4 +/- 1.8% (mean +/- SD), to 7.3 +/- 1.2% (P less than 0.05) within the first 6 months of Novopen therapy. No increment of hypoglycaemia frequency and mean daily insulin requirements was observed. No ketoacidotic episode was noticed during the study. In conclusion, in this group of diabetic children, no long term metabolic improvement was obtained, despite excellent acceptability of the multiple injection regimen with Novopen.
ISSN:0340-6199
1432-1076
DOI:10.1007/BF01995851