title: Pre-mixed insulin delivered by disposable pen in the management of children with diabetes.
abstract: Pre-mixed insulin preparations are being used increasingly in the management of children with IDDM. Recently this form of insulin has been produced in a disposable insulin pen device. An open randomized 3-month crossover study was conducted to compare glycaemic control on a self-titrating insulin regimen with a pre-mixed (30:70) preparation, both given twice daily. The pre-mixed preparation was delivered by disposable pen. Forty children (age range 7-16 yr) entered the study. Mean +/- SEM glycosylated haemoglobin (HbA1 %) at the start of the study (13.1 +/- 0.6) compared with values at the end of the self-titrating (11.8 +/- 0.5) and pre-mixed periods (12.5 +/- 0.5), as well as blood glucose profiles taken at 3-weekly intervals, showed no significant change. Fourteen of the children were on insulin ratios other than 30:70 (range 10:90 to 50:50) and were unaffected by the switch (HbA1 at the start of the study 12.7 +/- 1; at the end of the self-titrating 11.5 +/- 0.8; and pre-mixed period 12.5 +/- 0.8). Twenty-one children continued on the pen for a further 12 months with no deterioration in control (HbA1 at the beginning and end of this period being 11.9 +/- 0.7 and 11.0 +/- 0.7, respectively). The children (95%) preferred the disposable pen and pre-mixed insulin regimen. Switching to pre-mixed insulin, while not improving, has no detrimental effect on glycaemic control.
authors.affiliation: Department of Child Health, Ninewells Hospital and Medical School, Dundee, Scotland.
authors.forename: M
authors.initials: M
authors.lastname: O'Hagan
authors.forename: S A
authors.initials: SA
authors.lastname: Greene
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004209:Disposable Equipment; D004435:Eating; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D013594:Syringes
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin