Insulin Glulisine Is Safe for Children and Adolescents With Type 1 Diabetes to Take Directly Before Meals

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Pharmacokinetics, prandial glucose control, and safety of insulin glulisine in children and adolescents with type 1 diabetes, by T. Danne and colleagues. Diabetes Care 28:2100-2105, 2005.

What is the problem and what is known about it so far?

Keeping a regular eating schedule can be hard for adults with type 1 diabetes, and it can be even harder for children and adolescents. Patients with diabetes who take regular insulin must take it 30-45 minutes before eating, which requires them to plan their mealtimes in advance. This is a difficult task for children and adolescents, and missed and wrong doses of insulin can cause high or low blood glucose levels that can lead to serious problems.

Why did the researchers do this particular study?

Because children and adolescents often eat different portions of food at different times, researchers wanted to find a type of insulin that would be safe for children with diabetes to take just before mealtime. They knew that insulin glulisine could be safely taken by adults right before a meal. Insulin glulisine is a fast-acting insulin, which means that it's designed so that it can be taken right before meals and quickly absorbed by the body. The researchers wanted to see if insulin glulisine was also safe and effective for children and adolescents.

Who was studied?

Ten children and ten adolescents who had type 1 diabetes. The children were between 5 and 11 years of age and the adolescents were between 12 and 17 years of age.

How was the study done?

Each child's height, weight, and long-term blood glucose levels were measured. To make sure they began the study with stable blood glucose levels, the children fasted after their evening meal the night before the study and were given insulin on the day of the study. Some of the children were given regular insulin, and some were give insulin glulisine two minutes before they were given a liquid meal. Then, the researchers studied their blood glucose levels to see which type of insulin was absorbed the fastest and helped the children to have normal glucose levels.

What did the researchers find?

Insulin glulisine was absorbed faster and spent less time going through the body than regular insulin. Insulin glulisine was much better than regular insulin at helping the body turn glucose into energy when taken immediately before a meal. These results helped the researchers to conclude that insulin glulisine was safe and effective for children and adolescents to take right before a meal.

What are the limitations of the study?

Both the children and the adolescents were given the same amount of insulin, even though they were given meals of different sizes, which may have affected the results.

Because it is hard to keep children on a regular eating schedule, it might be easier to give them insulin glulisine after a meal. However, researchers did not study whether this is safe for children or adolescents.

What are the implications for the study?

This study shows that insulin glulisine is a safe and effective way for children and adolescents to take insulin closer to their actual mealtimes. The discovery of a fast-acting insulin that can be taken right before a meal can help children and adolescents to control their blood glucose levels better and can allow them more options when choosing when and how much they eat.

FOR MORE INFORMATION

For Parents and Kids: Types of Insulin

ADA Guide to Raising a Child With Diabetes, 2nd edition, by Linda Siminerio and Jean Betschart (Alexandria, VA, ADA, 2005)

Insulin glulisine provides improved glycemic control in patients with type 2 diabetes, by G. Dailey and colleagues. Diabetes Care 27:2363–2368, 2005.