[Insulin glargine improves fasting blood glucose levels in prepubertal children with unsatisfactorily controlled type 1 diabetes].
The aim of this prospective cross-over study was to compare glycemic control on NPH insulin (NPH) and on glargine in unsatisfactorily controlled type 1 diabetic prepubertal children.


METHODS
14 patients, aged 6-12 years, on multiple insulin injections regimen were included. The study protocol: (i) a 6-month therapy with NPH as basal insulin and (ii) a 6-month therapy with glargine as basal insulin, in a random order.


RESULTS
After 4 and 6 months mean blood glucose levels were similar on glargine and on NPH. After 6 months on NPH fasting blood glucose levels were similar to baseline (9.3+/-1.5 and 9.8+/-1.6 mmol/l respectively), while on glargine they were significantly lower compared to baseline (8.0+/-1.4 vs. 9.8+/-1.6 mmol/l, p=0.04) and markedly lower than after 6 months on NPH (8.0+/-1.4 vs. 9.3+/-1.5 mmol/l, p=0.077). HbA1c was lower on glargine compared to NPH, but only after 4 months the difference was statistically significant (7.1+/-0.16 vs. 7.74+/-0.25%, p=0.007). No severe hypoglycemia or ketoacidosis occurred.


CONCLUSIONS
In preadolescent children with unsatisfactorily controlled type 1 diabetes glargine constitutes a useful and safe alternative to NPH, providing better early morning and good total glycemic control, not increasing the risk of severe hypoglycemia; taking it into account the health care systems should participate in its costs for those who can not afford or tolerate an insulin pump.
Mianowska
Beata
B
Department of Pediatrics, Pediatrics I, Medical University of Łodz, ul. Sporna 36/50, Łodz, Poland. cima@binar.pl
Szadkowska
Agnieszka
A
Czerniawska
Elzbieta
E
Pietrzak
Iwona
I
Bodalski
Jerzy
J
D001786:Blood Glucose / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007328:Insulin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000494:pharmacology* / Q000627:therapeutic use; D049528:Insulin, Long-Acting; D008297:Male; D011627:Puberty; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D007336:Insulin, Isophane