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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
PubMed

Insights

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.
Abstract

Keywords:
aspart-detemir mixturediabetes childrenhypoglycemiatype 1 diabetes

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