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SHR Neuro Cancer Cardio Lipid Metab Microb
Fröhlich-Reiterer, EE; Ong, KK; Regan, F; Salzano, G; Acerini, CL; Dunger, DB.
A randomized cross-over trial to identify the optimal use of insulin glargine in prepubertal children using a three-times daily insulin regimen.
Diabet Med. 2007; 24(12):1406-1411
Doi: 10.1111/j.1464-5491.2007.02277.x
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Fröhlich-Reiterer Elke
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- Abstract:
- AIMS: The long-acting insulin analogue glargine reduces nocturnal hypoglycaemia and stabilizes morning blood glucose levels in patients with Type 1 diabetes (T1DM) on multiple injection therapy. However, young children may not tolerate such intensive insulin regimens. We investigated the effects of glargine in various three-injections-daily insulin combinations on 24-h glucose control in prepubertal children. METHODS: Seventeen T1DM prepubertal children (10 boys), median age 10.2 years (range 6.0-12.4), glycated haemoglobin (HbA(1c)) 8.8% (6.8-11.5) were recruited to a randomized, open-label, cross-over study. After a 2-week run-in period (with NPH pre-bed), every child underwent three different 3-week treatment blocks in random order. All treatment blocks included glargine pre-bed, but used different morning insulins: block 1, soluble only; block 2, soluble + NPH; block 3, aspart + NPH. Continuous glucose monitoring was performed for 3 days at the end of the run-in and each treatment block. RESULTS: Compared with the run-in period on NPH, the three glargine treatment blocks were associated with lower (P < 0.0001) and less variable (P < 0.05) pre-breakfast glucose levels, and with an 8-15% reduction in total daily insulin dose (P < 0.0001). Risk of nocturnal hypoglycaemia detected by continuous glucose monitoring varied significantly between the three glargine treatment blocks, and was lowest when children were given aspart + NPH in the morning (block 3). CONCLUSION: Insulin glargine pre-bed can be used in three-injections-daily regimens in prepubertal children to lower and stabilize pre-breakfast glucose levels. However, to avoid the risk of nocturnal hypoglycaemia, the pre-bed glargine dose should be lowered by giving a further long-acting insulin, such as NPH, in the morning.
- Find related publications in this database (using NLM MeSH Indexing)
- Blood Glucose - analysis
- Child - analysis
- Cross-Over Studies - analysis
- Diabetes Mellitus, Type 1 - drug therapy
- Drug Administration Schedule - drug therapy
- Drug Therapy, Combination - drug therapy
- Humans - drug therapy
- Hypoglycemic Agents - adverse effects
- Injections, Subcutaneous - adverse effects
- Insulin - adverse effects
- Male - adverse effects
- Prospective Studies - adverse effects
- Find related publications in this database (Keywords)
- children
- glargine
- hypoglycaemia
- three times daily
- Type 1 diabetes