Original article
Mixing rapid-acting insulin analogues with insulin glargine in children with type 1 diabetes mellitus

Presented in part at the 65th Scientific Sessions of the American Diabetes Association, San Diego, California, June 2005.
https://doi.org/10.1016/j.jpeds.2005.11.036Get rights and content

Objective

To determine whether mixing insulin glargine (IG) with a rapid-acting insulin (RAI) analogue in the same syringe had any deleterious effects on glycemic control in children with type 1 diabetes mellitus.

Study design

Data from 55 children mixing the IG with a RAI analogue was collected for 6 months before and 6 months after the insulin mixing began. Data from a control group of 55 children not mixing the insulins was collected at similar intervals. Parameters evaluated included hemoglobin A1c (HbA1c) values, number of non-severe and severe hypoglycemic events, number of diabetic ketoacidosis (DKA) events, and blood glucose distribution patterns.

Results

After 6 months of study, HbA1c values were equivalent for the control and test groups (8.54 ± 1.14 vs 8.61 ± 1.14, respectively; P = 1.0000). Percentages of blood glucose values in, above, and below the target range did not vary significantly in the groups. There were no significant differences in the groups in the occurrence of non-severe or severe hypoglycemic events or of DKA events.

Conclusion

There were no significant differences in glycemic control between children who mixed IG in the same syringe with a RAI analogue compared with children who took separate injections.

Section snippets

Participants

On the basis of the short-term data reported by Kaplan et al, several providers in our diabetes clinic told their patients they could start mixing IG and RAI in the same syringe. The children and adolescents in this study were observed prospectively by their diabetes care provider. Their medical records were reviewed retrospectively to assess any difference in glycemic control when IG was mixed in the same syringe with a RAI analogue (aspart or lispro) compared with when it was taken in a

Results

The 2 groups were equivalent at baseline in age, duration of T1D, and HbA1c . Data were available for all patients at 3 months follow-up. Ninety-three patients completed the study at 6 months (mix group n = 44; control group n = 49). At 3 and 6 months follow-up, the percentage of SMBG values in, above, and below the target range did not vary significantly between or within the control and mix groups (all P = not significant, data not shown). Likewise, there were no significant differences in

Discussion

These results indicate that there is no significant difference in glycemic control between children and adolescents who mix IG in the same syringe with a RAI analogue and those who take IG as a separate injection. The findings are especially encouraging to those patients who wish to minimize the number of total daily injections because of needle fear, forgetting injections, or other injection-related issues. The ability to mix IG in the same syringe with a RAI analogue presents the possibility

References (8)

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Supported by a grant (M01 RR00069) from the General Clinical Research Centers Program, National Centers for Research Resources, National Institutes of Health.

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