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Effect of Postmeal Fast-Acting Insulin Aspart Injection on the Frequency of Hypoglycemia among Pre-School Children

Arti Yadav1, Rakesh Kumar2, Devi Dayal1

  • 1Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.

Indian Journal of Pediatrics
|October 20, 2023
PubMed

Insights

Administering Fast-acting insulin Aspart (Fiasp) before or after meals showed no difference in hypoglycemia frequency for preschool children with type 1 diabetes. This study found no impact on glycemic control or safety outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management
  • Pharmacokinetics

Background:

  • Type 1 diabetes (T1D) management in preschool children presents unique challenges.
  • Optimizing insulin delivery timing is crucial for glycemic control and minimizing hypoglycemia.
  • Fast-acting insulin analogs, like Fiasp, offer potential for flexible dosing.

Purpose of the Study:

  • To compare the frequency of hypoglycemia when Fast-acting insulin Aspart (Fiasp) is administered postmeal versus premeal.
  • To evaluate the impact of Fiasp injection timing on glycemic control and parental satisfaction in young children with T1D.

Main Methods:

  • A single-center, randomized crossover trial involving 65 preschool children (6 months to 6 years) with T1D.
  • Participants received Fiasp meal bolus either premeal or postmeal for 3 months, followed by a crossover.
  • Outcomes included hypoglycemia/hyperglycemia frequency, HbA1c, glycemic variability, and parental satisfaction.

Main Results:

  • No significant differences were observed in the frequency of clinical, severe, or serious hypoglycemia between premeal and postmeal Fiasp administration.
  • Secondary outcome parameters, including HbA1c and glycemic variability, showed no significant differences between the groups.
  • Pharmacokinetic studies in a subset of children also revealed no differences.

Conclusions:

  • The timing of Fiasp injection (premeal vs. postmeal) does not influence the frequency of hypoglycemia in preschool children with Type 1 diabetes.
  • Glycemic control parameters and safety profiles are comparable regardless of Fiasp administration timing in this age group.
Abstract

Keywords:
HypoglycemiaInsulinPre-school childrenType 1 diabetes

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