PEDIATRICS Vol. 108 No. 5 November 2001, pp. 1175-1179
Insulin Lispro Lowers Postprandial Glucose in Prepubertal Children With Diabetes
Received Dec 18, 2000; accepted Jun 21, 2001.
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From the * Children's Clinic, Tallahassee, Florida; Objective. This study compared the
glucose-lowering effect of insulin lispro, given before or after meals,
with regular human insulin given before meals in prepubertal children
with diabetes.
Research Design and Methods. A 3-way crossover, open-label
study involving 61 prepubertal children (ages 2.9-11.4 years) with
type 1 diabetes. The children were randomly assigned to receive regular
human insulin 30 to 45 minutes before meals, insulin lispro within 15 minutes before or immediately after meals, combined with basal insulin.
Each treatment lasted 3 months. Hemoglobin A1c levels and
home glucose monitoring profiles were measured at the end of each
treatment period.
Results. Treatment with insulin lispro before breakfast
resulted in lower 2-hour postprandial glucose values than regular human
insulin (11.7 ± 4.4 mmol/L vs 15.0 ± 5.4 mmol/L).
Similarly, insulin lispro given before dinner resulted in lower blood
glucose values 2 hours postprandially (8.8 ± 5.0 mmol/L vs
10.8 ± 5.4 mmol/L) than regular human insulin. When insulin
lispro was administered after meals, the 2-hour glucose levels were
between those seen with either insulin lispro or regular human insulin
given before meals. The number and types of adverse events, the rates
of hypoglycemia, and the HbA1c levels did not differ among
the 3 therapies.
Conclusions. In prepubertal children, insulin lispro given
before meals is safe and significantly lowers postprandial glucose
levels after breakfast and dinner compared with regular human insulin,
and insulin lispro given after the meal provides similar benefits as
regular human insulin before the meal.
Lilly
Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana;
§ New England Diabetes and Endocrinology Center, Waltham,
Massachusetts; Children's Hospital of Western Ontario, London,
Ontario, British Columbia; ¶ Children's Hospital, Vancouver, British
Columbia; # Hospital for Sick Children, Vancouver, British Columbia; and
** International Diabetes Center, Minneapolis, Minnesota.
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