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PEDIATRICS Vol. 100 No. 6 December 1997, pp. 968-972

Effectiveness of Postprandial Humalog in Toddlers With Diabetes

Received Mar 3, 1997; accepted Jun 10, 1997.

K. Suchari Rutledge*, H. Peter Chase*, Georgeanna J. Klingensmith*, Philip A. Walravens*, Robert H. Slover*, and Satish K. Garg*, Dagger

From the Departments of * Pediatrics and * Dagger  Internal Medicine, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, Colorado.

Objective.  The purpose of this study was to determine whether postprandial administration of the new rapid-acting insulin analog Humalog could effectively reduce glucose excursions in children <5 years old.

Design.  Human Regular insulin given before a meal was compared with the same dose of Humalog after a meal of equal carbohydrate content in five toddlers with insulin-dependent (type 1) diabetes mellitus. In addition, the use of Humalog before a meal was compared with Humalog given after a meal of equal carbohydrate content in five other toddlers. The dose of long-acting insulin was not changed during the study period. Blood glucose levels were determined at fasting and at 1, 2, and 4 hours postprandially.

Results.  The 2-hour glucose excursions were significantly lower when postprandial Humalog administration was compared with preprandial Human Regular insulin administration. In contrast, glucose excursions were similar when Humalog was taken before or after the meal.

Conclusion.  These data show that it is efficacious to give Humalog insulin postprandially in toddlers with type 1 diabetes, allowing increased safety for the young child. The insulin dose can be both matched to the actual food intake and timed to give families increased flexibility and control at mealtime.

Key words: insulin-dependent diabetes mellitus, Humalog, toddlers, eating problems, postprandial.




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