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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Veröffentlicht in:Diabetic medicine 2003-08, Vol.20 (8), p.656-660
Hauptverfasser: 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.
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container_end_page 660
container_issue 8
container_start_page 656
container_title Diabetic medicine
container_volume 20
creator 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.
description 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 (
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E. ; Murphy, N. P. ; Moore, E. J. ; Edge, J. A. ; Ong, K. L. ; Watts, A. P. ; Acerini, C. L. ; Dunger, D. B.</creator><creatorcontrib>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.</creatorcontrib><description>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 (&lt; 3.5 mmol/l) was lower on lispro (8% of blood glucose levels) than on soluble insulin (13%, P = 0.01). In the early morning (04.00–07.00 h) mean blood glucose and prevalence of low levels were no different between the two treatment groups, and fasting (07.00 h) blood glucose levels were similar (6.1 ± 0.8 vs. 6.3 ± 0.9 mmol/l, P = 0.8). At the end of each treatment arm there were no differences in HbA1c (lispro vs. soluble 8.6% vs. 8.4%, P = 0.3), or in insulin doses (mean, range 0.97, 0.68–1.26 vs. 0.96, 0.53–1.22 U/kg per day, P = 0.2). Conclusions The shorter duration of action of insulin lispro given before the evening meal may reduce the prevalence of early nocturnal hypoglycaemia without compromising HbA1c in young children with T1DM.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1046/j.1464-5491.2003.01013.x</identifier><identifier>PMID: 12873294</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>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 &amp; control ; Hypoglycemic Agents - therapeutic use ; Insulin - analogs &amp; derivatives ; Insulin - therapeutic use ; Insulin Lispro ; Medical Records ; Medical sciences ; nocturnal hypoglycaemia ; Risk Factors ; Type 1 diabetes</subject><ispartof>Diabetic medicine, 2003-08, Vol.20 (8), p.656-660</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4333-54b8e4dab4f24562207ae74eb45fda4592ceb868fbfc1842026d334d1f6802973</citedby><cites>FETCH-LOGICAL-c4333-54b8e4dab4f24562207ae74eb45fda4592ceb868fbfc1842026d334d1f6802973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1464-5491.2003.01013.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1464-5491.2003.01013.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1413,27906,27907,45556,45557</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14943596$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12873294$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ford-Adams, M. E.</creatorcontrib><creatorcontrib>Murphy, N. P.</creatorcontrib><creatorcontrib>Moore, E. J.</creatorcontrib><creatorcontrib>Edge, J. A.</creatorcontrib><creatorcontrib>Ong, K. L.</creatorcontrib><creatorcontrib>Watts, A. P.</creatorcontrib><creatorcontrib>Acerini, C. L.</creatorcontrib><creatorcontrib>Dunger, D. B.</creatorcontrib><title>Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>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 (&lt; 3.5 mmol/l) was lower on lispro (8% of blood glucose levels) than on soluble insulin (13%, P = 0.01). In the early morning (04.00–07.00 h) mean blood glucose and prevalence of low levels were no different between the two treatment groups, and fasting (07.00 h) blood glucose levels were similar (6.1 ± 0.8 vs. 6.3 ± 0.9 mmol/l, P = 0.8). At the end of each treatment arm there were no differences in HbA1c (lispro vs. soluble 8.6% vs. 8.4%, P = 0.3), or in insulin doses (mean, range 0.97, 0.68–1.26 vs. 0.96, 0.53–1.22 U/kg per day, P = 0.2). Conclusions The shorter duration of action of insulin lispro given before the evening meal may reduce the prevalence of early nocturnal hypoglycaemia without compromising HbA1c in young children with T1DM.</description><subject>Biological and medical sciences</subject><subject>Blood Glucose - analysis</subject><subject>Child</subject><subject>children</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>Hypoglycemia - prevention &amp; control</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - analogs &amp; derivatives</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Lispro</subject><subject>Medical Records</subject><subject>Medical sciences</subject><subject>nocturnal hypoglycaemia</subject><subject>Risk Factors</subject><subject>Type 1 diabetes</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1v1DAQhi0EokvhLyBf4Jbgr8QJEgcopVQqRSBQj5bjTLpeHCfYCd38exx21V452fI8r2fmQQhTklMiyje7nIpSZIWoac4I4TmhhPJ8_wht7guP0YZIwTJOJD1Bz2LcEUJZzeun6ISySnJWiw0aLn2cnfXY2TiG4S3WeBwm8JPVDofBAU61McCf9cnfYj-YaQ4-FbfLONy6xWjorV6pZZgTYLbWtQE8vrPTFrdWNzBBxD04Z6c5PkdPOu0ivDiep-jnp_MfZ5-zq68Xl2fvrzIjOOdpgaYC0epGdEwUJWNEapACGlF0rRZFzQw0VVl1TWdoJRhhZcu5aGlXVoTVkp-i14d_01K_Z4iT6m00aQjtYZijklwkqqYJrA6gCUOMATo1BtvrsChK1Cpb7dTqVK1O1Spb_ZOt9in68thjbnpoH4JHuwl4dQR0NNp1QXtj4wMnElPUZeLeHbg762D57wHUxy_n6y3ls0Pexgn293kdfqlSclmom-sLJW74t-p7_UFd878L_KtK</recordid><startdate>200308</startdate><enddate>200308</enddate><creator>Ford-Adams, M. E.</creator><creator>Murphy, N. P.</creator><creator>Moore, E. J.</creator><creator>Edge, J. A.</creator><creator>Ong, K. L.</creator><creator>Watts, A. P.</creator><creator>Acerini, C. L.</creator><creator>Dunger, D. B.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200308</creationdate><title>Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus</title><author>Ford-Adams, M. E. ; Murphy, N. P. ; Moore, E. J. ; Edge, J. A. ; Ong, K. L. ; Watts, A. P. ; Acerini, C. L. ; Dunger, D. 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B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ford-Adams, M. E.</au><au>Murphy, N. P.</au><au>Moore, E. J.</au><au>Edge, J. A.</au><au>Ong, K. L.</au><au>Watts, A. P.</au><au>Acerini, C. L.</au><au>Dunger, D. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2003-08</date><risdate>2003</risdate><volume>20</volume><issue>8</issue><spage>656</spage><epage>660</epage><pages>656-660</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>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 (&lt; 3.5 mmol/l) was lower on lispro (8% of blood glucose levels) than on soluble insulin (13%, P = 0.01). In the early morning (04.00–07.00 h) mean blood glucose and prevalence of low levels were no different between the two treatment groups, and fasting (07.00 h) blood glucose levels were similar (6.1 ± 0.8 vs. 6.3 ± 0.9 mmol/l, P = 0.8). At the end of each treatment arm there were no differences in HbA1c (lispro vs. soluble 8.6% vs. 8.4%, P = 0.3), or in insulin doses (mean, range 0.97, 0.68–1.26 vs. 0.96, 0.53–1.22 U/kg per day, P = 0.2). Conclusions The shorter duration of action of insulin lispro given before the evening meal may reduce the prevalence of early nocturnal hypoglycaemia without compromising HbA1c in young children with T1DM.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>12873294</pmid><doi>10.1046/j.1464-5491.2003.01013.x</doi><tpages>5</tpages></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete
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
title Insulin lispro: a potential role in preventing nocturnal hypoglycaemia in young children with diabetes mellitus
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