Comparison of glycemic variability associated with insulin glargine and intermediate-acting insulin when used as the basal component of multiple daily injections for adolescents with type 1 diabetes.
OBJECTIVE
To compare the glucose variability associated with insulin glargine and NPH/Lente insulin used as the basal insulin component of a multiple daily injection (MDI) regimen in pediatric patients with type 1 diabetes.


METHODS
Continuous glucose monitoring data were collected from a subset of patients (n = 90) who agreed to use a continuous glucose monitoring system during an active-controlled, randomized, open-label study evaluating the safety and efficacy of insulin glargine and NPH/Lente insulin used with insulin lispro as part of an MDI regimen.


RESULTS
Treatment with insulin glargine resulted in significant reductions in glucose variability as measured by the SD of glucose values (adjusted mean change from baseline to week 24: -13.4 mg/dl [-0.74 mmol/l]; P <or= 0.05), mean amplitude of glycemic excursion (-34.4 mg/dl [-1.91 mmol/l]; P <or= 0.0001), and M value (-9.6 mg/dl [-0.53 mmol/l]; P <or= 0.03). The corresponding reductions in glucose variability for NPH/Lente were not significant.


CONCLUSIONS
Insulin glargine is associated with greater reductions in glucose variability than NPH/Lente insulin in pediatric patients with type 1 diabetes.
White
Neil H
NH
Department of Pediatrics and Medicine, Pediatric Patient-Oriented Research Unit, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri, USA. white_n@kids.wustl.edu
Chase
H Peter
HP
Arslanian
Silva
S
Tamborlane
William V
WV
D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007267:Injections / Q000379:methods*; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000008:administration & dosage / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D007336:Insulin, Isophane