Preliminary data of insulin glargine use among Thai adolescents and young adults with type 1 diabetes mellitus treated at Siriraj Hospital.
Insulin glargine is a new long-acting insulin analog with a duration of action of 24 hours and can be given once a day as the only basal insulin combined with short or rapid-acting insulin as bolus insulin for each meal. The goals of this study were to evaluate short term result of treatment with insulin glargine compared to NPH and to determine the initial dosage of insulin glargine in Thai adolescents with type 1 diabetes. We reviewed charts of 10 adolescents (median age 20.8 years, range 12.3-22.7 years) with type 1 diabetes who had received insulin glargine for > or = 4 months (median 16.5 months, range 4-25 months). Before switching to insulin glargine, all patients received NPH. Seventy percent of subjects had improvement of HbA1c from 10.4% (range 8.2-12.6) to 8% (range 6.7-10.6). The total amount of insulin dosage was significantly decreased from 1.2 (range 0.9-2.4) to 0.9 (range 0.4-1.5) units/kg/day as well as the percentage of basal insulin which was decreased from 70% (range 67-81) to 47% (range 38-56) of the total daily insulin. Insulin glargine did not cause severe hypoglycemia in this study.


CONCLUSIONS
Insulin glargine is another promising therapy for adolescents with type 1 diabetes. We recommend the starting total daily insulin dosage to be decreased to 70-80% of previous dosage. Insulin glargine should be started at 50% of the new total daily insulin dosage.
Sawathiparnich
Pairunyar
P
Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sipry@mahidol.ac.th
Kiattisakthavee
Pornpimol
P
Santiprabhob
Jeerunda
J
Likitmaskul
Supawadee
S
D000293:Adolescent; D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D061267:Insulin Aspart; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D008297:Male; D012189:Retrospective Studies; D013785:Thailand
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D061267:Insulin Aspart