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Special management of insulin lispro in continuous subcutaneous insulin infusion in young diabetic children: a

Nadia Tubiana-Rufi1, Regis Coutant, Juliette Bloch

  • 1Department of Pediatric Endocrinology and Diabetology, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, France. n.tubiana@free.fr

Hormone Research
|November 4, 2004
PubMed

Insights

Insulin lispro (LP) in continuous subcutaneous insulin infusion (CSII) therapy is safe and effective for young children with diabetes, improving mealtime glucose control and parental satisfaction. Nocturnal basal rates may need adjustment to prevent early morning hyperglycemia.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Pharmacotherapy

Background:

  • Continuous subcutaneous insulin infusion (CSII) is a key treatment for type 1 diabetes in children.
  • Insulin lispro (LP), a rapid-acting insulin analog, is increasingly used in pediatric CSII.
  • Comparing LP with regular human insulin (RH) is crucial for optimizing pediatric diabetes care.

Purpose of the Study:

  • To evaluate the safety, efficacy, and management of insulin lispro (LP) versus regular human insulin (RH) in young children with diabetes using CSII.
  • To assess glycemic control, hypoglycemia, and device-related complications.
  • To determine parental satisfaction and quality of life impact.

Main Methods:

  • An open-label, randomized cross-over study involving 27 very young children (mean age 4.6 years) with diabetes on CSII.
  • Two 16-week treatment periods comparing LP and RH.
  • Data collected on HbA1c, glucose levels, hypoglycemia, infections, catheter occlusions, and parental feedback.

Main Results:

  • No significant differences in HbA1c, hypoglycemia, or catheter issues were observed between LP and RH.
  • LP showed a trend towards lower prandial glucose excursions, particularly at dinner.
  • Higher mean blood glucose levels occurred during early morning hours (00:00-03:00) with LP, necessitating basal rate adjustments.
  • Parents reported improved daily life ease and preferred LP.

Conclusions:

  • Insulin lispro is a safe and effective alternative to RH in pediatric CSII, offering improved postprandial glucose control.
  • LP enhances daily life for young diabetic children and their parents, leading to greater satisfaction.
  • Careful monitoring and adjustment of nocturnal basal insulin rates are essential during LP therapy to mitigate early morning hyperglycemia.
Abstract

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