Objective
To determine the effects of omitting meal time insulin on arterial stiffness in children with type 1 diabetes.
Research design and methods
In this prospective, randomized, crossover study, radial artery tonometry and augmentation index adjusted to heart rate 75 (AI75) were used to measure arterial stiffness. Children were randomized to receive or omit premeal insulin and completed the crossover portion of the study on a subsequent day. AI75 was determined when fasting, 1, and 2 h postmeal.
Results
When comparing change in AI75 from baseline to 1 h and baseline to 2 h, when subjects received premeal insulin vs. no insulin, AI75 was 4.5 units lower at 1 h (p = 0.011, 95% CI:1.1 lower to 8 lower) and 4.3 units lower at 2 h (p = 0.062, 95% CI: 0.2 higher to 8.9 lower) (n = 40).
Conclusions
Arterial stiffness is decreased by premeal insulin in children with type 1 diabetes.