title: Insulin lispro lowers postprandial glucose in prepubertal children with diabetes.
abstract: OBJECTIVE
  This study compared the glucose-lowering effect of insulin lispro, given before or after meals, with regular human insulin given before meals in prepubertal children with diabetes.
  
  
  METHODS
  A 3-way crossover, open-label study involving 61 prepubertal children (ages 2.9-11.4 years) with type 1 diabetes. The children were randomly assigned to receive regular human insulin 30 to 45 minutes before meals, insulin lispro within 15 minutes before or immediately after meals, combined with basal insulin. Each treatment lasted 3 months. Hemoglobin A(1c) levels and home glucose monitoring profiles were measured at the end of each treatment period.
  
  
  RESULTS
  Treatment with insulin lispro before breakfast resulted in lower 2-hour postprandial glucose values than regular human insulin (11.7 +/- 4.4 mmol/L vs 15.0 +/- 5.4 mmol/L). Similarly, insulin lispro given before dinner resulted in lower blood glucose values 2 hours postprandially (8.8 +/- 5.0 mmol/L vs 10.8 +/- 5.4 mmol/L) than regular human insulin. When insulin lispro was administered after meals, the 2-hour glucose levels were between those seen with either insulin lispro or regular human insulin given before meals. The number and types of adverse events, the rates of hypoglycemia, and the HbA(1c) levels did not differ among the 3 therapies.
  
  
  CONCLUSIONS
  In prepubertal children, insulin lispro given before meals is safe and significantly lowers postprandial glucose levels after breakfast and dinner compared with regular human insulin, and insulin lispro given after the meal provides similar benefits as regular human insulin before the meal.
authors.affiliation: Children's Clinic, Tallahassee, Florida 32308, USA. lcdeeb@attglobal.net
authors.forename: L C
authors.initials: LC
authors.lastname: Deeb
authors.forename: J H
authors.initials: JH
authors.lastname: Holcombe
authors.forename: R
authors.initials: R
authors.lastname: Brunelle
authors.forename: S
authors.initials: S
authors.lastname: Zalani
authors.forename: S
authors.initials: S
authors.lastname: Brink
authors.forename: M
authors.initials: M
authors.lastname: Jenner
authors.forename: H
authors.initials: H
authors.lastname: Kitson
authors.forename: K
authors.initials: K
authors.lastname: Perlman
authors.forename: M
authors.initials: M
authors.lastname: Spencer
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D001786:Blood Glucose / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006441:Hemoglobin A / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D061268:Insulin Lispro; D008297:Male; D019518:Postprandial Period
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; D006441:Hemoglobin A