Insulin Aspart and Lispro Equivlent for Insulin Pumps

A group of investigators led by Dr Stuart Weinzimer of Yale University School of Medicine in New Haven, CT, USA, compared the safety and efficacy of continuous subcutaneous insulin infusion (CSII) using insulin aspart with insulin lispro in children and adolescents with type 1 diabetes. Nearly 300 patients aged 4-18 years were randomized to insulin aspart CSII (n=198) or insulin lispro CSII (n=100) for 16 weeks. All patients had a duration of diabetes of 1 year or more, and had been treated with CSII for 3 or more months prior to study entry. Age-specific targets for HbA1c were defined according to the American Diabetes Association (ADA) criteria (<8.5% for patients aged less than 6 years, and <8% for patients aged 6-18 years).

The investigators found that the change in HbA1c after 16 weeks was not inferior with insulin aspart CSII, compared with insulin lispro CSII (-0.15% vs -0.05%; p=0.241). More patients treated with insulin aspart CSII achieved age-specific targets for HbA1c (59.7% vs 43.8%; p=0.040). Daily insulin dose was lower in patients treated with insulin aspart CSII (0.86U/kg vs 0.94U/kg; p=0.018). Rates of hypoglycemic events were similar in the two treatment groups.

The investigators concluded that, in children and adolescents with type 1 diabetes, insulin aspart CSII was as safe and effective as insulin lispro CSII.

Diabetes Care 2007 [Epub ahead of print]