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2 . 2022

Dynamics of the target range parameters of glycemia on the therapy with ultrafast insulin aspart in children with type 1 diabetes mellitus


Aim – ​to assess the dynamics of the target range parametres of glycemia after the switching from insulin aspart to ultrafast insulin aspart in children with type 1 diabetes mellitus (T1DM).

Design – ​prospective, open, uncontrolled comparative study.

Material and methods. 16 children, aged 4–17 years, who have T1DM for more than 1 year participated in the study. The group included children with insulin pump therapy and basal bolus insulin therapy with multiple daily injections. Insulin degludek was used as basal insulin for at least 6 months. Bolus insulin aspart was replaced by fast-acting insulin aspart. According to the results of flash glucose monitoring before the insulin switching patients were divided into 2 groups depending on the glycemic variability (coefficient of variation, CV): 1st group – ​with low glycemic variability (CV≤36%), 2nd group – ​with high glycemic variability (CV>36%). Time in/above/below range (level 1, level 2) of the ambulatory glucose profile using the intermittently scanned FreeStyle Libre flash glucose monitoring system (FGM) was assessed. Time in, below, and above the target range was recorded from 4 periods of 14-day glucose monitoring: before insulin switching and 2 weeks, 3 months and 6 months after changing insulin.

Results. According to FGM results six months after the start of fast insulin aspart therapy in 1st group there was a statistically non-significant increase in Time In Range (TIR) values, a decrease in Time Above Range (TAR) and Time Below Range (TBR) values. Glycohemoglobin (HbA1c) and glycemic variability also improved without statistical significance.

2nd group showed a statistically significant increase in TIR after 6 months of using fast insulin aspart (from 40.5±11.2 to 60.0±8.0; p<0.001), decrease in TAR (from 50.8±9.3 to 33.0±7.4; p<0.001) and in TBR (from 11.5±5.4 to 5.2±3.6; p<0.001), CV (from 39.6±3.8 to 34.5±2.8; p<0.001), that had an impact on a statistically significant decrease in the level of HbA1c (from 8.6±1.4 to 6.8±0.7; p<0.05) in the same group of patients.

Conclusion. Usage of ultrafast insulin aspart in children with T1DM allowed to improve the indicators of carbohydrate metabolism: the time in/above/below range (level 1, level 2), the glycemic variability according to the ambulatory glucose profile.

Keywords:type 1 diabetes mellitus; glycemia; continuous monitoring; FreeStyle Libre; flash glucose monitoring; ultrafast-acting insulin

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Girsh Ya.V., Yusupova N.A. Dynamics of the target range parameters of glycemia on the therapy with ultrafast insulin aspart in children with type 1 diabetes mellitus. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 21–6. DOI: (in Russian)


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Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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