In a nutshell
This study investigated the effect of diluting insulin aspart (B28Asp human insulin) in children aged 3-6 with type 1 diabetes.
Some background
Insulin is typically the first treatment for type 1 diabetes patients. One of the methods of delivery is via an insulin pump. In closed-loop insulin delivery, blood glucose is continuously monitored. Based on blood glucose levels, the pump calculates the correct dosage of insulin to release. The insulin is released into the fatty tissues beneath the skin. Absorption of insulin by the fatty tissue causes a delay of delivery to the blood. This delay can lead to blood glucose levels getting dangerously high or low. It has been suggested that dilution of insulin aspart increases its absorption rate.
Methods & findings
This study aimed to determine whether dilution of insulin aspart increased absorption rate. 11 children with type 1 diabetes took part in the trial. The children visited the hospital twice to be tested. On one visit, the child was given an insulin aspart dosage at standard concentration (100 U/ml). On the other visit the child was given diluted insulin apart (20 U/ml). Children who received diluted insulin aspart were given a higher volume of the drug so that they received the correct dosage.
At each visit, insulin aspart was delivered following an evening meal. The dosage was based on the carbohydrate content of the meal and the current blood glucose levels of the child. After the initial dosage of insulin aspart, the pump adjusted the dosage according to blood glucose levels every 15 minutes. The absorption and response to insulin aspart was measured until 8am the following morning.
No difference was found between the absorption rate of standard insulin or diluted insulin. However for each child, the time taken for insulin levels to peak after delivery of insulin was less variable when children were given diluted insulin.
The bottom line
This study concluded that dilution of insulin aspart did not change the rate of absorption, but did reduce the variability. The authors suggested that using diluted insulin aspart may help caregivers to more accurately predict insulin levels during closed-loop insulin delivery.
The fine print
The sample size of this study was very small. Findings need to be confirmed by larger studies.
What’s next?
Consult your doctor if you wish to discuss using diluted insulin aspart for insulin pump treatment.
Published By :
Diabetologia
Date :
Dec 27, 2014
