Comparison of the efficacy and safety of insulin glargine and insulin detemir with NPH insulin in children and adolescents with type 1 diabetes mellitus receiving intensive insulin therapy

Abstract

Objective: The purpose of this study was to compare the efficacy and safety of insulin glargine and detemir with NPH insulin in children and adolescents with type 1 diabetes mellitus (DM). Methods: Thirty four children and adolescents with type 1 DM (mean age 12.7 ± 3.4 years, diabetes duration 5.4 ± 3.0 years) were included in the study. All patients had been receiving intensive insulin therapy with insulin aspart and NPH for at least 6 months before switching from NPH to insulin glargine (Group 1, n=19) or detemir (Group 2, n=15). The medical records obtained within 6 months before and after treatment with insulin glargine and detemir were retrospectively reviewed and the data were compared in each group. Results: The mean age and duration of DM were similar in two groups (p>0.05). In both groups, switching from NPH to insulin glargine or detemir, resulted in a reduction in HbA1c (p<0.05, for both). At the end of 6 months of treatment, no significant differences were observed between the glargine- and detemir-treated groups with respect to HbA1c. Daily insulin requirements, mean fasting blood glucose levels and frequency of severe hypoglycemia before and after treatment with glargine and detemir were not significantly different (p>0.05, for both). Patients in the detemir treated group had less increment in body mass index (BMI) SDS at the end of 6 months of therapy compared to NPH and glargine treated patients (p>0.05, for both). No side effects were noted throughout the study. Conclusion: Both insulin glargine and detemir improved HbA 1c at short-term and proved to be safe and well tolerated in children and adolescents with type 1 DM. © 2009 Journal of Turkish Pediatric Endocrinology and Diabetes Society.