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Premeal insulin decreases arterial stiffness in children with type 1 diabetes

Colette S Meehan1, Pooja L Kethireddy1, Jordan K Ashcraft1

  • 1Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA.

Pediatric Diabetes
|May 14, 2016
PubMed

Insights

Administering premeal insulin in children with type 1 diabetes significantly reduces arterial stiffness. This study highlights the importance of mealtime insulin for cardiovascular health in pediatric diabetes management.

Area of Science:

  • Cardiovascular physiology
  • Pediatric endocrinology
  • Diabetes research

Background:

  • Arterial stiffness is an early indicator of cardiovascular risk.
  • Type 1 diabetes in children is associated with an increased risk of cardiovascular complications.
  • Mealtime insulin is crucial for glycemic control in type 1 diabetes.

Purpose of the Study:

  • To investigate the impact of omitting premeal insulin on arterial stiffness in children with type 1 diabetes.
  • To assess the role of mealtime insulin in modulating vascular function in pediatric diabetes.

Main Methods:

  • Prospective, randomized, crossover study design.
  • Radial artery tonometry used to measure arterial stiffness, quantified by augmentation index adjusted to heart rate 75 (AI75).
  • Participants received or omitted premeal insulin and measurements were taken at fasting, 1-hour, and 2-hour postmeal time points.

Main Results:

  • A significant reduction in AI75 was observed at 1 hour postmeal when premeal insulin was administered compared to omission (4.5 units lower, p=0.011).
  • A trend towards lower AI75 was noted at 2 hours postmeal with premeal insulin (4.3 units lower, p=0.062).
  • The study included 40 children with type 1 diabetes.

Conclusions:

  • Premeal insulin administration effectively decreases arterial stiffness in children with type 1 diabetes.
  • Maintaining mealtime insulin therapy may be beneficial in mitigating early cardiovascular risk in pediatric patients with type 1 diabetes.
Abstract

Keywords:
CVD riskarterial stiffnessbolus insulinmeal insulin

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