Efficacy of Humalog® injections before an afternoon meal and their acceptance by children and adolescents with Type 1 diabetes

Abstract

We conclude that an injection of insulin lispro before the afternoon meal can effectively lower the before-dinner blood glucose, and in boys also lowers the HbA1c. Patients were satisfied with the lower blood glucose before dinner, and did not find the insulin lispro injection difficult. However, compliance with the protocol procedures decreased during a subsequent 6-month period.

Mixing Insulin Aspart With Detemir Does Not Affect Glucose Excursion in Children With Type 1 Diabetes

“…One of the barriers to good glycemic control in children with type 1 diabetes is multiple daily insulin injections (1,2). Mixing rapid-acting and slow-acting insulins in the same syringe would decrease the number of injections and may improve adherence (3,4).…”

Pharmacokinetics, Prandial Glucose Control, and Safety of Insulin Glulisine in Children and Adolescents With Type 1 Diabetes

“…Children and adolescents sometimes encounter difficulties in adjusting their daily activities to fixed intervals between insulin administration and meals, particularly with regular human insulin (RHI), which requires administration 30 -45 min before mealtime (2). The use of rapid-acting insulin analogs instead of RHI for prandial glycemic control is becoming increasingly accepted, since these insulins can be given much closer to mealtime (2)(3)(4). Thus, rapid-acting insulin analogs might offer advantages, particularly for very young children in whom the actual carbohydrate intake is often difficult to predict (5).…”

Using an injection port helps improve metabolic control and compliance to a strict basal‐bolus regimen in children and adolescents with type 1 diabetes

“…In Group A, the I-PORT Advance helped maintain good glycemic control bypassing the discomfort of frequent skin punctures. Martin et al 2 reported that an extra injection of insulin before the afternoon meal could effectively lower blood glucose before dinner and, in some patients, also HbA1c; unfortunately, they found that compliance with these procedures decreased during the study period, probably due to the need for extra skin punctures. 6 Notably, the subjects in that study already had a good mean baseline HbA1c (7.3%), which was stable until the end of the study (7.1% after 10 weeks), as seen in Group A in the present study (there was a slight reduction in HbA1c in Group A that was not statistically significant).…”

“…1 In fact, the body's physical growth, management of frequent snacks and mistakes in carbohydrate counting and insulin boluses require the ability to promptly adapt the insulin regimen. 2,3 Using devices for subcutaneous insulin administration aims to increase compliance with treatment, without limiting lifestyle flexibility, bypassing the fear of needles and discomfort of insulin injections. 4 Poor conflicting results on metabolic control published so far 5,6 means the use of such devices is not as widespread as expected.…”