Lipoatrophy in children, adolescents and adults with insulin pump treatment: Is there a beneficial effect of insulin glulisine?
Journal
Pediatric diabetes
ISSN: 1399-5448
Titre abrégé: Pediatr Diabetes
Pays: Denmark
ID NLM: 100939345
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
02
04
2020
revised:
18
06
2020
accepted:
22
07
2020
pubmed:
2
8
2020
medline:
19
11
2021
entrez:
2
8
2020
Statut:
ppublish
Résumé
To investigate whether zinc-free insulin is an effective treatment option for lipoatrophy. Controlled, randomized, open-label parallel study in young people with type 1 diabetes, pump treatment and lipoatrophy at injection sites. Participants underwent dermatological examination and evaluation of affected areas using ultrasound and magnetic resonance imaging (MRI). After randomization, half of themswitched to insulin glulisine (intervention group) for 6 months. The control group continued their treatment with zinc-containing insulin and switched to insulin glulisine 6 months later. Both groups were followed-up until month 12. Primary endpoint was the increase of the relative thickness of the subcutaneous fat layer of the most atrophic site at 6 months as documented by MRI. Fourteen participants were included into the study. While relative thickness of subcutaneous fat tissue was comparable between intervention (-60% [-98.8 - -17.6], n = 7) and control group (-50% [-72.7 - -1.0], P = .511; median (range), n = 7)at baseline, it improved in the intervention (-14.3% [-85.7-83.3] vs -31.3% (-66.7-0), P = .031), but not in the control group (P = .125) after 6 months. At 12 months, relative fat thickness (P = .003), number (P = .015) and size of most atrophic sites (P = .001) were improved in the intervention group. Number (P = .018) and size of most atrophic sites (P = .008) were also reduced in the control group between 6 and 12 months. Although the present pilot study is based on a small sample, the data give first hint that the use of the zinc-free insulin glulisine may be beneficial in people with diabetes, pump and lipoatrophy.
Substances chimiques
Hypoglycemic Agents
0
Insulin
0
insulin glulisine
7XIY785AZD
Banques de données
ClinicalTrials.gov
['NCT02914886']
EudraCT
['2015‐004536‐35']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1285-1291Informations de copyright
© 2020 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.
Références
Kordonouri O, Lauterborn R, Deiss D. Lipohypertrophy in young patients with type 1 diabetes. Diabetes Care. 2002;25:634.
Famulla S, Hövelmann U, Fischer A, et al. Insulin Injection Into Lipohypertrophic Tissue: Blunted and More Variable Insulin Absorption and Action and Impaired Postprandial Glucose Control. Diabetes Care. 2016;39:1486-1492.
Schernthaner G. Immunogenicity and allergenic potential of animal and human insulins. Diabetes Care. 1993;16(Suppl 3):155-165.
Radermecker RP, Pierard GE, Scheen AJ. Lipodystrophy reactions to insulin: effects of continuous insulin infusion and new insulin analogs. Am J CinDermatol. 2007;8:21-28.
Holstein A, Stege H, Kovacs P. Lipoatrophyassociatedwith the use of insulin glargine and review of the literature. Expert Opin Drug Saf. 2010;9:225-231.
Kordonouri O, Biester T, Schnell K, et al. Lipoatrophy in childrenwith type 1 diabetes: an increasingincidence? J Diabetes SciTechnol. 2015;9:206-208.
Lopez X, Castells M, Ricker A, Velazquez EF, Mun E, Goldfine AB. Human insulin analog-inducedlipoatrophy. Diabetes Care. 2008;31:442-444.
Neu A, Bürger-Büsing J, Danne T, et al. Diagnosis, therapy and follow-up of diabetes mellitus in children and adolescents. Exp Clin Endocrinol Diabetes. 2019;127:341-352.
Danne T, Phillip M, Buckingham BA, et al. ISPAD clinical practice consensus guidelines 2018: insulin treatment in children and adolescents with diabetes. Pediatr Diabetes. 2018;19(Suppl 27):115-135.
Watanabe K, Kusunoki Y, Katsuno T, et al. A case of type 1 diabetes mellitus with which localized insulin allergy was markedly alleviated by switching to insulin glulisine. Acta Diabetol. 2016;53:845-848.
Chantelau EA, Praetor R, Praetor J, Poll LW. Relapsing insulin-induced lipoatrophy, cured by prolonged low-dose oral prednisone: a case report. Diabetol Metab Syndr. 2011;3:33.
Ramos AJ, Farias MA. Human insulin-induced lipoatrophy: a successful treatment with glucocorticoid. Diabetes Care. 2006;29:926-927.
Bode BW. Comparison of pharmacokinetic properties, physicochemical stability, and pump compatibility of 3 rapid-acting insulin analogues-aspart, lispro, and glulisine. EndocrPract. 2011;17:271-280.