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Long-term Improvement of Fasting Glycaemia after Switching Basal Insulin from NPH to Determir in Children with Type 1 Diabetes: A 1-Year Multicentre Study


Authors: Z. Šumník 1;  J. Venháčová 2;  L. Brázdová 3;  J. Škvor 4
Authors‘ workplace: Pediatrická klinika 2. LF UK a FNM, Praha 1;  Dětská klinika LF UP a FN, Olomouc 2;  Diabetologická ambulance, Nemocnice Milosrdných bratří, Brno 3;  Dětská klinika Masarykovy nemocnice, Ústí nad Labem 4
Published in: Čas. Lék. čes. 2008; 147: 421-425
Category: Original Article

Overview

Background.
Paper presents an evaluation of diabetes control after switching from NPH insulin to detemir in children with type 1 diabetes.

Methods and Results.
We performed a non-randomized, observational, multicentre study on the first group of children whose treatment switched from NPH to insulin detemir in four centers of paediatric diabetes. A total of 72 children (39 boys and 33 girls) were included in the analysis. The average age at intervention was 10.6 ± 4.7 yrs, the average age at diabetes onset was 6.2 ± 4.3 yrs. Diabetes control was assessed 3 months prior to the switch and subsequently during 3-month intervals.

Results:
Mean HbA1c decreased from 6.9% at baseline to 6.4% after 3 months of detemir therapy (p = 0.0003). However, in the next months we observed a trend for increasing the HbA1c, and no statistically significant difference in HbA1c was observed at the 6, 9 and 12 months visits vs. baseline. Fasting glycaemia decreased significantly after 3 months of treatment with detemir in comparison with the baseline (the mean value of the difference was 2.1 mmol/l, CI 95% 1.5–2.6, p = 1.4*10-10), and this effect was detectable during all the observational period (month 12 vs. baseline 2.6 mmol/l, p < 10-8).

Conclusions.
Switching basal insulin from NPH insulin to detemir resulted in a short-term improvement of HbA1c, and a long-term decreasing of fasting glycaemia.

Key words:
type 1 diabetes, insulin analogues, detemir, NPH insulin, children.


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