MMPAD Munich Meeting Report

MEETING REPORT 13 European Roadshow - Friday 25 th May, 2018 Munich, Germany Various insulins • Ultra-rapid acting insulin was approved for adults by the European Commission and the FDA in 2017, and is currently being tested in paediatric patients in clinical trials. According to Karges, ultra-rapid acting insulin – injected 20 minutes after starting a meal – is equally as effective as insulin aspart which is injected during meals. The concentration in the first 30 minutes is twice as high as that of insulin aspart. • Rapid-acting insulin analogues – For children, three rapid-acting insulin preparations are available: insulin aspart, insulin glulisine and insulin lispro . They are given as bolus injections during meals and may also be administered via pumps, immediately prior and/or after meals. During meals it is easier to assess the amount a child will eat. Young children benefit in particular as they can sometimes be hesitant to eat. Comparisons of the three rapid-acting insulin preparations in young children revealed no statistically significant differences. PRACTICAL INSULIN TREATMENT Presented by Professor Beate Karges - RWTH Aachen University There are many insulin preparations, and these differ in onset and efficacy duration as well as in peak concentrations (Figure 3) . The choice of insulin, however, depends on many other factors, including lifestyle habits of the patient and his/her family, emphasised presenter Beate Karges. The speaker stressed the fact that there are no safety concerns in children, adolescents and pregnant women when it comes to analogues and biosimilars. She also talked about the development of antibodies, but these do not have any influence on insulin dosage or HbA1c values. Fig. 3 : Different duration of action and peak levels as well as different onset of action of various insulins and analogues (Slide: Karges) . 2 • Regular insulin is a short-acting human insulin and is the main ingredient of most substitution therapies worldwide. It is given as a bolus injection 20 to 30 minutes before meals and may also be administered intravenously. In the USA, the inhalation method as prandial insulin in adults has also been approved. • Intermediate-acting insulin , also referred to as isophane NPH (neutral protamine Hagedorn) , must be mixed