A comparison of postprandial and preprandial administration of insulin aspart in children and adolescents with type I diabetes

被引:95
作者
Danne, T
Aman, J
Schober, E
Deiss, D
Jacobsen, JL
Friberg, HH
Jensen, LH
机构
[1] Kinderkrankenhaus Bult, Diabet Zentrum Kinder & Jugendliche, D-30173 Hannover, Germany
[2] Reg Hosp, Barn & Ungdomskliniken, Dept Paediat, Orebro, Sweden
[3] Univ Klin Kinder & Jugendheilkunde, Vienna, Austria
[4] Charite, Klin Allgemeine Padiatrie, Berlin, Germany
[5] Novo Nordisk AS, DK-2880 Bagsvaerd, Denmark
关键词
D O I
10.2337/diacare.26.8.2359
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - The aim of this Study was to compare the glycemic control of preprandial versus postprandial injections of the new rapid-acting insulin analogue aspart in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS - Forty-two children (aged 6-12 years) and 34 adolescents (13-17 years) were randomized to preprandial (immediately before meal start) and postprandial (immediately after a meal or a maximum of 30 min after meal start) treatment with insulin aspart (at least thrice daily) as part of a basal/bolus regimen in a multicenter study with an open labeled, two-period cross-over design (6-week periods). Of this group, 49% were boys, 55% were aged less than or equal to13 years, and duration of diabetes was 4.4 years (range 1.0-9.4). RESULTS - Glycerine control for postprandial treatment was not worse than preprandial treatment as assessed by fructosamine week 0 vs. 6 (mean +/- ID, preprandial 367 +/- 74 vS. 378 +/- 90 90 mumol/l, postprandial 383 +/- 83 vs. 385 +/- 77 mumol/l) and HbA(1c) (preprandial 7.9 +/- 1.3 vS 8.0 +/- 1.5%; postprandial 8.0 +/- 1.4 vs. 8.3 +/- 1.5%, P = 0.14). The only statistically significant finding from the seven-point blood glucose profiles and derived parameters between preprandial and postprandial treatment was a lower postprandial glucose level 120 min after breakfast (mean +/- SEM, -2.08 +/- 0.74 mmol/l, P = 0.016). The relative risk of hypoglycemia (blood glucose <3.9 mmol/l preprandially to postprandially was not significantly different (mean 1.1; 95% CI 0.91-1.35 P = 0.31). Overall treatment satisfaction was equally high for both regimens with both patients and parents. CONCLUSIONS - Although preprandial administration of insulin aspart is generally Preferable, this study shows that in children and adolescents, postprandial administration of insulin aspart is a sale and effective alternative.
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页码:2359 / 2364
页数:6
相关论文
共 24 条
[1]   Efficacy, safety, and pump compatibility of insulin aspart used in continuous subcutaneous insulin infusion therapy in patients with type 1 diabetes [J].
Bode, BW ;
Strange, P .
DIABETES CARE, 2001, 24 (01) :69-72
[2]  
BRANGE J, 1994, HDB PSYCHOL DIABETES, P111
[3]   Post-prandial administration of the insulin analogue insulin aspart in patients with Type 1 diabetes mellitus [J].
Brunner, GA ;
Hirschberger, S ;
Sendlhofer, G ;
Wutte, A ;
Ellmerer, M ;
Balent, B ;
Schaupp, L ;
Krejs, GJ ;
Pieber, TR .
DIABETIC MEDICINE, 2000, 17 (05) :371-375
[4]   The impact of the Diabetes Control and Complications Trial and Humalog insulin or glycohemoglobin levels and severe hypoglycemia in type 1 diabetes [J].
Chase, HP ;
Lockspeiser, T ;
Peery, B ;
Shepherd, M ;
MacKenzie, T ;
Anderson, J ;
Garg, SK .
DIABETES CARE, 2001, 24 (03) :430-434
[5]   Contribution of postprandial versus interprandial blood glucose to HbA1c in type 1 diabetes on physiologic intensive therapy with lispro insulin at mealtime [J].
Ciofetta, M ;
Lalli, C ;
Del Sindaco, P ;
Torlone, E ;
Pampanelli, S ;
Mauro, L ;
Chiara, D ;
Brunetti, P ;
Bolli, GB .
DIABETES CARE, 1999, 22 (05) :795-800
[6]   Experience with insulin analogues in children [J].
Danne, T ;
Deiss, D ;
Hopfenmüller, W ;
von Schütz, W ;
Kordonouri, O .
HORMONE RESEARCH, 2002, 57 :46-53
[7]  
Gale EAM, 2000, DIABETIC MED, V17, P209
[8]   Direct comparison of insulin lispro and aspart shows small differences in plasma insulin profiles after subcutaneous injection in type 1 diabetes [J].
Hedman, CA ;
Lindstrom, T ;
Arnqvist, HJ .
DIABETES CARE, 2001, 24 (06) :1120-1121
[9]   Reducing hypoglycaemia with insulin analogues [J].
Heller, S .
INTERNATIONAL JOURNAL OF OBESITY, 2002, 26 (Suppl 3) :S31-S36
[10]   Insulin aspart vs. human insulin in the management of long-term blood glucose control in Type 1 diabetes mellitus: a randomized controlled trial [J].
Home, PD ;
Lindholm, A ;
Riis, A .
DIABETIC MEDICINE, 2000, 17 (11) :762-770