Usefulness of insulin detemir in Japanese children with type 1 diabetes.
BACKGROUND
This multicenter observational study was conducted to investigate the efficacy and safety of insulin detemir (detemir) for diabetes management in Japanese children and adolescents.


METHODS
Data from the Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes database were analyzed. Ninety children (32 boys, 58 girls; mean age, 11.9 ± 3.8 years) who transferred from a neutral protamine Hagedorn insulin or insulin glargine basal-bolus regimen to detemir basal-bolus therapy and who were observed for at least 12 months were identified. Clinical data obtained at 0, 3, 6, and 12 months were analyzed to determine the type of bolus insulin used, number and timing of detemir injections, detemir dose as a proportion of the total insulin dose, hemoglobin A1c (HbA1c), fasting blood glucose (FBG) and frequency of severe hypoglycemia.


RESULTS
Twelve months after switching to detemir, the detemir dose represented 39.8% of the total insulin dose, and 37.8% of patients were being treated with twice-daily injections. HbA1c and FBG were significantly reduced from baseline at 3 and 6 months but not at 12 months. Considering the seasonal HbA1c variation in the Japanese population, a separate analysis was performed using data for 65 children (21 boys, 44 girls; mean age, 11.6 ± 2.9 years) who switched to detemir during the winter. Subset analysis showed significant HbA1c reductions from baseline at all specified times. The incidence of severe hypoglycemia during detemir treatment was 4.4 episodes per 100 patient-years.


CONCLUSIONS
Detemir is an effective and safe basal insulin for diabetes management in Japanese children and adolescents.
Department of Pediatrics, West Japan Railway Company Hiroshima General Hospital, Hiroshima, Japan.
Kazuhiko
K
Jinno
Tatsuhiko
T
Urakami
Reiko
R
Horikawa
Tomoyuki
T
Kawamura
Nobuyuki
N
Kikuchi
Tohru
T
Kikuchi
Rika
R
Kizu
Kitaro
K
Kosaka
Haruo
H
Mizuno
Takahiro
T
Mochizuki
Aki
A
Nishii
Yukashi
Y
Ohki
Shun
S
Soneda
Shigetaka
S
Sugihara
Toshi
T
Tatematsu
Shin
S
Amemiya
D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007279:Injections, Subcutaneous; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D007564:Japan / Q000453:epidemiology; D008297:Male; D009017:Morbidity / Q000639:trends; D012189:Retrospective Studies; D016896:Treatment Outcome
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir