Higher insulin detemir doses are required for the similar glycemic control: comparison of insulin detemir and glargine in children with type 1 diabetes mellitus.

Abstract

OBJECTIVE:

We aimed to compare hemoglobin A1c (HbA1c), total and basal insulin doses, basal insulin injection frequencies, and body mass index (BMI) in children with type 1 diabetes mellitus (T1DM) who are receiving detemir and glargine as basal insulin in a basal-bolus therapy.

METHOD:

This retrospective study included 117 (53 females) children and adolescents with T1DM older than 4 yr of age, minimum diabetes duration of 2 yr, and receiving basal-bolus insulin regimen (at least 4 injections/d, insulin aspart or lispro as bolus insulin). Comparisons were made for those receiving insulin detemir (n = 32) or glargine (n = 85) as the basal insulin.

RESULTS:

Age, pubertal status, BMI standard deviation scores, and diabetes duration were similar in detemir and glargine groups. Glycemic control was similar in both groups (HbA1c levels 8.9 ± 2.1% vs. 8.5 ± 1.7% for detemir and glargine, respectively; p = 0.497). Both mean basal insulin (0.52 vs. 0.41 U/kg/d, p < 0.001) and mean total daily insulin (1.11 vs. 0.93 U/kg/d, p < 0.001) doses were higher in the detemir group. Furthermore, higher ratio of twice-daily basal insulin injection was detected in the detemir group (62.5 vs. 32.9% p = 0.004). Subgroup analysis according to pubertal status, or the number of daily basal injections showed similar results.

CONCLUSION:

Insulin detemir provides similar glycemic control with glargine, but, approximately 27% higher mean basal and 19% higher mean total insulin doses with two-fold more twice-daily basal insulin injection requirement.

• Authors: Saygın Abalı, Serap Turan, Zeynep Atay, Tülay Güran, Belma Haliloğlu, Abdullah Bereket
• Journal: Pediatric diabetes (Pediatr Diabetes) Vol. 16 Issue 5 Pg. 361-6 (Aug 2015) ISSN: 1399-5448 [Electronic] Denmark
• PMID: 25039448 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Insulin Glargine
• Insulin Detemir

Topics

• Adolescent
• Blood Glucose (drug effects, metabolism)
• Child
• Diabetes Mellitus, Type 1 (blood, drug therapy)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Female
• Glycated Hemoglobin (analysis)
• Humans
• Hypoglycemic Agents (administration & dosage)
• Injections
• Insulin Detemir (administration & dosage)
• Insulin Glargine (administration & dosage)
• Male
• Retrospective Studies
• Treatment Outcome