84 ABUSE OF RAPID-ACTING INSULIN ANALOGUE IN TYPE 1 DIABETES MELLITUS CARE : A 13-YEAR-OLD BOY CASE

• Published in: Clinical Pediatric Endocrinology Vol. 12; no. 2; p. 131
• Main Authors: Kitayama N, Nakamura N, Tsuru N, Hirose S
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Pediatric Endocrinology 2003
• ISSN: 0918-5739; 1347-7358

Rapid-acting insulin analogue (RAIA) is a useful drug for treating type 1 diabetes mellitus. RAIS is believed to improve diabetes care reducing adverse events of insulin therapy. However, elevation of HbA1c level may also be observed in some cases after switching regular insulin to RAIA for some reasons. We report a 13-year-old boy with type 1 diabetes mellitus whose diabetes control was deteriorated because of abuse of RAIA. His diabetes was diagnosed at 9 years old and has been well controlled by subcutaneous injections of regular and NPH insulin for three years. His HbA1c level ranged from 5.0 to 6.6% during the period. He switched regular insulin RAIA at 12 years old. Since hypoglycemia attacks and hypergl ycemia episodes occurred frequently. Hi s HbA1c level gradually elevated and reached to 8.8% within six months of the new regime with insulin analogue. His obesity index also increased from 9.7% to 31%. However, a good glycemic control was achieved when he was in hospital. It was revealed that he had extra foods with an injection of RAIA several times a day besides regular postprandial use. RAIA opened a new avenue in clinical diabetes care. At the same time, abuse of RAIA such as this case should be recognized as a pitfall of RAIA use especially in treating adolescents and young adults.