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Insulin lispro versus regular insulin in children with type 1 diabetes on twice daily insulin

J M Fairchild1, G R Ambler, C H Genoud-Lawton

  • 1The Ray Williams Institute of Paediatric Endocrinology, Diabetes and Metabolism, The New Children's Hospital, Westmead, Parramatta, NSW, Australia. janf@nch.edu.au

Pediatric Diabetes
|March 16, 2004
PubMed

Insights

Insulin lispro offers convenience for children with diabetes without worsening glycemic control compared to regular insulin. Higher 3 am blood glucose levels with insulin lispro may reduce nocturnal hypoglycemia.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Pharmacology

Background:

  • Twice-daily insulin therapy is common for prepubertal children with type 1 diabetes.
  • Insulin lispro, a rapid-acting insulin analog, offers potential convenience over regular insulin.
  • Comparing the efficacy and safety of these insulins in young children is crucial for optimizing treatment.

Purpose of the Study:

  • To compare the clinical efficacy and safety of insulin lispro versus regular insulin in prepubertal children (5-10 years) on twice-daily insulin regimens.
  • To assess glycemic control and hypoglycemia frequency with both insulin types.

Main Methods:

  • An open-label, randomized crossover study involving 35 children.
  • Children received insulin lispro and regular insulin for 3 months each, alongside intermediate-acting insulin.
  • Glycemic control was monitored via blood glucose profiles and HbA1c; hypoglycemia was documented.

Main Results:

  • Endpoint HbA1c levels were similar between insulin lispro (8.33%) and regular insulin (8.14%).
  • No significant differences in pre/post-meal glucose, postprandial excursions, or bedtime glucose.
  • Regular insulin resulted in significantly lower 3 am blood glucose levels compared to insulin lispro.

Conclusions:

  • Insulin lispro provides greater convenience for children on twice-daily insulin without compromising glycemic control.
  • The higher 3 am glucose levels observed with insulin lispro may potentially reduce nocturnal hypoglycemia.
  • Both insulin types demonstrated similar safety profiles regarding hypoglycemic episodes.
Abstract

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