Introduction: Rapid-acting insulin analogues have been developed to mimic more closely the physiological action of endogenous insulin. However, they still have a delayed onset of action and a longer duration compares to endogenous insulin. Therefore, newer insulin analogues have been developed with a faster onset and a shorter duration of action.
Aim: To evaluate the efficacy of rapid-acting insulin analogues (Novorapid) vs a faster acting insulin (Fiasp) in children and adolescents with type 1 diabetes (TIDM) treated with sensor-augmented pump (SAP).
Materials and Methods: This was a randomized cross-over study conducted in 33 children and adolescents (60,6% males, median age 12 years) with TIDM using SAP. Most of the participants were receiving Novorapid before the initiation of the study (51.5%), while 3 out of 10 (30.3%) were receiving lispro (Humalog). After randomization, 21 participants (52,4% males) received Fiasp and 12 NovoRapid and crossed over after 3 months. Height, weight, BMI, daily total insulin dose, HbA1c, percentage of time spent in euglycemic range (TIR), time above range (TAR), time below range (TBR) and time of sensor use were reported at the study onset, 3 and 6 months afterwards.
Results: There was a significant difference in the total daily insulin dose per kg at three and six months in the group of Fiasp (P=0.034 and 0.028 respectively) compared to base line which was not observed in those receiving Novo Rapid. Furthermore, there was no difference between the two groups regarding daily insulin dose per Kg at 6 months. No difference was observed regarding HbA1C, TIR, TAR, TBR, BMI, BMI-Zscore and duration of sensor use at 3 and 6 months between the two groups. However, 70% of participants decided to continue with Fiasp after the end of the study.
Conclusion: Fiasp and NovoRapid are equally efficient in children and adolescents with TIDM treated with SAP with no difference in glycemic control.
15 Sep 2022 - 17 Sep 2022