Humalog insulin has been available for use since August 1996. In prior studies performed in children, the addition of Humalog led to lower postprandial blood sugars, fewer nocturnal hypoglycemic events, and increased convenience with respect to meal timing. However, HgbA1C values were not significantly lower. We have a large pediatric population of patients with type 1 diabetes using Humalog. We did a chart review of our patients using Humalog for all or part of their rapid acting insulin for at least 6 months. To be included, patients had to have been diagnosed at least 1.5 years prior to beginning Humalog and must have been on a regimen in the past that did not contain Humalog. 49 charts were chosen randomly for review after meeting the above criteria. A1C values at 3, 6 and 12 months after starting Humalog were compared to the average A1C during the six months prior to starting Humalog. Table 1 shows average A1C values. Normal A1C < 6.4.

Table 1 No caption available.
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Table 2 shows the percentage of patients with at least a 10% decrease in A1C.

Table 2 No caption available.
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A small percentage of patients increased their A1C values by 10% or greater; however, by 12 months, no patient had an A1C that was greater than 10% of their pre Humalog A1C.

The benefits of Humalog insulin have been shown in other studies to include decreased nocturnal hypoglycemia and increased patient convenience. In the few studies in children, none found improved glycemic control. Our study shows a benefit to overall glycemic control with Humalog as evidenced by statistically significant improvement in A1C values in both pubertal and prepubertal children.