Premeal insulin decreases arterial stiffness in children with type 1 diabetes

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 (AI 75 ) 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. AI 75 was determined when fasting, 1, and 2 h postmeal. Results When comparing change in AI 75 from baseline to 1 h and baseline to 2 h, when subjects received premeal insulin vs. no insulin, AI 75 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.