Use of insulin glargine in children under age 6 with type 1 diabetes.
OBJECTIVE
Children under 6 yr have the highest incidence of severe hypoglycemia (SH) and the greatest likelihood of brain damage from SH. The purpose of this study is to evaluate the use of insulin glargine (Lantus in children under age 6 with type 1 diabetes (T1D).


METHODS
The electronic medical records were reviewed for patients under age 6 during the first 6 months of insulin glargine therapy and compared with age, sex, and duration of diabetes for matched control patients on neutral protamine Hagedorn (NPH) insulin. Data from 128 subjects (32 male pairs and 32 female pairs) were collected relating to the incidence of severe and non-severe hypoglycemic events, hemoglobin A1c (HbA1c) values, body mass index (BMI), and daily insulin dose. Additionally, parents were asked to complete a diabetes Quality of Life (QoL) survey.


RESULTS
In the 6 months before the study period, the glargine group had 16 SH events compared with three in the 6 months post-glargine. The comparison (NPH) group had seven and six SH events in their respective 6-month periods. Nighttime SH events in the glargine group decreased from 12 prestudy events to one during the study period. The average daily insulin dose in the glargine group was higher than that in the NPH group (0.8+/- 0.2 vs. 0.7+/- 0.2 U/kg/day; p=0.03). The HbA1c values, BMI, and QoL responses were not significantly different between the two groups.


CONCLUSIONS
SH was decreased, particularly at night (from 12 episodes to one), after the introduction of glargine in young children with T1D.
Dixon
Brenner
B
Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Denver, CO, USA.
Peter Chase
H
H
Burdick
Jonathan
J
Fiallo-Scharer
Rosanna
R
Walravens
Philippe
P
Klingensmith
Georgeanna
G
Rewers
Marian
M
Garg
Satish K
SK
D015992:Body Mass Index; D002675:Child, Preschool; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008297:Male; D011788:Quality of Life
D006442:Glycated Hemoglobin; D007328:Insulin; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting