Comparison of the Effect of Insulin Glulisine to Insulin Aspart on Breakfast Postprandial Blood Glucose Levels in Children with Type 1 Diabetes Mellitus on Multiple Daily Injections

Cemeroğlu, Ayşe Pínar; Kleis, Lora; Wood, Andrew R.; Parkes, C; Wood, Mark; Davis, Alan T.

doi:10.4158/ep12399.or

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…Although the incidence of hypoglycemia at the 2-and 4-h postprandial time points was similar for both GLU and ASP, an insignificant trend toward a higher incidence of hypoglycemia was observed in the ASP-GLU group. These findings are consistent with those presented by Cemeroglu et al (11). The authors showed significantly more hypoglycemic events 2 and 4 h after H-GI food ingestion with ASP than with GLU.…”

Section: Discussionsupporting

confidence: 93%

“…We did not observe any statistical differences in grams of CHO per kilogram of body weight between the study groups. In comparison, in the study carried out by Cemeroglu et al (11), the subjects ingested different types of products (with a similar GI) with 45, 60, or 75 g of CHO, so the glycemic load was even more unstable.…”

Section: :4mentioning

confidence: 92%

“…Considering these facts, we hypothesized that GLU should lead to a better postprandial profile than ASP after the consumption of H-GI meals. Although there are a few studies that have compared the properties of rapid-acting insulin analogs in adults (7,8,9,10), the number of studies in a pediatric population is still limited (10,11).…”

Section: Introductionmentioning

confidence: 99%

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Impact of insulins glulisine and aspart on postprandial glycemia after a high-glycemic index meal in children with type 1 diabetes

Dżygało

Szypowska

2014

European Journal of Endocrinology

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Objective: According to current knowledge, glulisine insulin (GLU) has a slightly faster onset of action than aspart (ASP) insulin. Therefore, GLU might lead to a better postprandial profile than ASP following the consumption of high-glycemic index (H-GI) meals. The aim of this study was to assess differences in the action of GLU and ASP after the consumption of a H-GI meal in type 1 diabetic children treated with insulin pumps. Design: Fifty-six type 1 diabetic children of mean age 14.7G2.0 years were included in a randomized, double-blind, two-way crossover study. The subjects were allocated to one of two treatment orders: GLU-ASP and ASP-GLU. They were given a H-GI breakfast for two subsequent days. Methods: The primary outcome was postprandial glycemia (PPG) based on continuous glucose monitoring system and self monitoring of blood glucose levels during 3 h of follow-up. The secondary outcomes were the frequency of hypoglycemia, glucose area under the curve, mean amplitude of glycemic excursion, and glycemic rise. Results: There were no significant differences between the groups with regard to PPG in the determined time intervals as well as with respect to the secondary outcomes. Between 60 and 120 min after food consumption in both study groups, blood glucose levels were close to or above 10.0 mmol/l. Glucose peaks were higher in the GLU-ASP group than in the ASP-GLU group (90 min: PZ0.065; 120 min: PZ0.052). Most of the episodes of hypoglycemia were observed after the second hour of follow-up. Conclusions: No statistically significant difference was found between GLU and ASP with regard to PPG after the consumption of a H-GI breakfast. Neither GLU nor ASP stabilized the glycemic profile after the consumption of a H-GI meal.

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Section: Discussionsupporting

confidence: 93%

Section: :4mentioning

confidence: 92%

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Impact of insulins glulisine and aspart on postprandial glycemia after a high-glycemic index meal in children with type 1 diabetes

Dżygało

Szypowska

2014

European Journal of Endocrinology

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“…No clinical significant differences have been found between the analogs 25 also in the pediatric population. 26 The different rapid acting analogs have different chemical properties, but no significant clinical difference in time of action and duration has been reported [27][28][29] ; their advantages compared to regular (soluble) insulin are still under debate. The Cochrane review from 2016 stated that in patients with type 1 diabetes, the weighted mean difference of HbA1c was −0.1% in favor of insulin analog (−0.2% when using CSII).…”

Section: Rapid Acting Insulin Analogsmentioning

confidence: 99%

ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes

et al. 2018

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“…Insulin aspart was compared with insulin glulisine in 13 children with T1D, aged 5.4–11.8 years and using multi-injection therapy [ 97 ]. Results indicated that use of insulin aspart was associated with a lower postprandial glucose excursion at 2 h (+98.6 ± 66.9 vs +113.5 ± 65.2 mg/dL, p = 0.01) and BG was lower with insulin aspart even at 4 h (129.0 ± 37.0 vs 141.9 ± 36.5 mg/dL, p = 0.04) after breakfast.…”

Section: Clinical Efficacy Of Insulin Aspartmentioning

confidence: 99%

Insulin Aspart in the Management of Diabetes Mellitus: 15 Years of Clinical Experience

Hermansen

Bohl

Schioldan

2015

Drugs

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Limiting excessive postprandial glucose excursions is an important component of good overall glycemic control in diabetes mellitus. Pharmacokinetic studies have shown that insulin aspart, which is structurally identical to regular human insulin except for the replacement of a single proline amino acid with an aspartic acid residue, has a more physiologic time–action profile (i.e., reaches a higher peak and reaches that peak sooner) than regular human insulin. As expected with this improved pharmacokinetic profile, insulin aspart demonstrates a greater glucose-lowering effect compared with regular human insulin. Numerous randomized controlled trials and a meta-analysis have also demonstrated improved postprandial control with insulin aspart compared with regular human insulin in patients with type 1 or type 2 diabetes, as well as efficacy and safety in children, pregnant patients, hospitalized patients, and patients using continuous subcutaneous insulin infusion. Studies have demonstrated that step-wise addition of insulin aspart is a viable intensification option for patients with type 2 diabetes failing on basal insulin. Insulin aspart has shown a good safety profile, with no evidence of increased receptor binding, mitogenicity, stimulation of anti-insulin antibodies, or hypoglycemia compared with regular human insulin. In one meta-analysis, there was evidence of a lower rate of nocturnal hypoglycemia compared with regular human insulin and, in a trial that specifically included patients with a history of recurrent hypoglycemia, a significantly lower rate of severe hypoglycemic episodes. The next generation of insulin aspart (faster-acting insulin aspart) is being developed with a view to further improving on these pharmacokinetic/pharmacodynamic properties.

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Comparison of the Effect of Insulin Glulisine to Insulin Aspart on Breakfast Postprandial Blood Glucose Levels in Children with Type 1 Diabetes Mellitus on Multiple Daily Injections

Cited by 11 publications

References 11 publications

Impact of insulins glulisine and aspart on postprandial glycemia after a high-glycemic index meal in children with type 1 diabetes

Impact of insulins glulisine and aspart on postprandial glycemia after a high-glycemic index meal in children with type 1 diabetes

ISPAD Clinical Practice Consensus Guidelines 2018: Insulin treatment in children and adolescents with diabetes

Insulin Aspart in the Management of Diabetes Mellitus: 15 Years of Clinical Experience

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