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Decrease in clinical hypoglycemia in young children with type 1 diabetes treated with free-mixed aspart and detemir
C Petit-Bibal1, A Rothenbuhler1, P Lucchini1
1AP-HP, Department of Pediatric Endocrinology, Bicêtre Hospital, Paris Sud University, Pôle I3E, 94275, Le Kremlin Bicetre, France.
Pediatric Diabetes
|June 4, 2014
Summary
Free-mixing aspart and detemir insulins (ADIM) significantly reduced hypoglycemia in young children with type 1 diabetes compared to fixed-ratio premixed insulin (ANIM). This flexible approach improved diabetes management by lowering severe and symptomatic hypoglycemic events.
Area of Science:
- Endocrinology
- Pediatric Diabetes Management
- Pharmacology
Background:
- Type 1 diabetes (T1D) in children requires careful insulin management.
- Twice-daily insulin injections are common for pediatric T1D.
- Premixed insulins offer convenience but may lack flexibility.
Purpose of the Study:
- To compare the effectiveness of a free-mix of aspart and detemir insulins (ADIM) versus a fixed-ratio premixed insulin (aspart/NPH, ANIM).
- To evaluate the impact on hypoglycemia and glycemic control in young children with T1D.
- To assess the benefits of personalized insulin preparations over fixed mixtures.
Main Methods:
- An open-label, randomized trial involving 82 children with T1D.
- Patients initially received ANIM for one year of optimization.
- Subsequent randomization to either continued ANIM or ADIM for a second year.
Main Results:
- ADIM significantly reduced symptomatic hypoglycemia by approximately twofold (p < 0.001).
- ADIM decreased severe hypoglycemia by 7-10 fold (p = 0.04).
- Mean HbA1c levels were comparable between ADIM (7.9%) and ANIM (8.2%) groups.
Conclusions:
- Free-mixing aspart and detemir insulins effectively reduces hypoglycemia in pediatric T1D.
- ADIM offers a safer alternative to fixed-ratio premixed insulins in young children.
- Personalized insulin regimens may improve safety without compromising glycemic control.
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