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Insulin Lispro Injection Effective For Lowering Before-Dinner Blood Glucose In Type 1 Diabetes
A DGReview of :"Efficacy of Humalog injections before an afternoon meal and their acceptance by children and adolescents with type 1 diabetes"
Diabetic Medicine
03/26/2003
By James Adams
An injection of insulin lispro prior to the afternoon meal effectively lowers before-dinner blood glucose levels in adolescents with type 1 diabetes.
Investigators from the Hopital Necker-Enfants Malades in Paris, France, studied 43 boys and girls aged 12.4 ± 2.4 years with type 1 diabetes. Twenty patients were randomly assigned to receive an injection of insulin lispro while the 23 were assigned to a control group that received no injection.
Both groups consumed identical meals for a two-month period. Mean before-dinner blood glucose was measured during the last two weeks of the study.
Patients in the treatment group ate an afternoon meal 11.4 ± 3/9 times per 15-day period. They gave themselves 8.9 ± 3.6 injections of insulin lispro during the same period of time. Controls ate 14.4 ± 0.6 afternoon meals during the same 15-day period.
Insulin lispro treatment resulted in a significantly lower before-dinner blood glucose level of 10.4 ± 3.8 millimoles/litre (mmol/L) in the treated group compared with 14.7 ± 3.9 mmol/L in the control group.
Treatment with insulin lispro also reduced the number of days that blood glucose was over 10 mmol/L by 50%.
In boys, the change in haemoglobin A1c from baseline to endpoint showed a slight but significant difference between treated and untreated groups. Haemoglobin A1c increased significantly in all patients with the number of meals taken without a corresponding injection.
Frequency of hypoglycaemia and changes in weight were similar between the two groups.
The investigators conclude that insulin lispro taken before an afternoon meal can lower before dinner blood glucose levels. It may also lower haemoglobin A1c in boys, they add.
Diabet Med 2002;19:12:1026-1031.
"Efficacy of Humalog injections before an afternoon meal and their acceptance by children and adolescents with type 1 diabetes"
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