Aims: To compare glycaemic control and weight gain in children with type 1 diabetes changing from twice daily premixed insulin to multiple daily injections (MDI) with either insulin glargine or insulin detemir.
Methods: A retrospective study of 41 consecutive children and adolescents with type 1 diabetes, changed to MDI between January 2005 and April 2007, with outcome measures of HbA1C change and body mass index SDS (BMI-SDS) change after 12 months of MDI. All children received insulin aspart boluses with meals in combination with either insulin glargine or insulin detemir.
Results: There were 24 children (11 males) in the insulin glargine group, median age 13.9 years (range 11.117 years), and 17 children (11 males) in the insulin detemir group, median age 13.8 years (11.818 years). The median insulin dose in the glargine group at start was 0.9 u/kg per day (0.61.34 u/kg per day) and at 12 months was 0.9 u/kg per day (0.461.88 u/kg per day). The median insulin dose in the detemir group at start was 0.9 u/kg per day (0.51.74 u/kg per day) and at 12 months was 1.0 u/kg per day (0.731.48 u/kg per day). The difference between the glargine and detemir starting and 12 month doses was not significant on T test.
The median HbA1C at the start of glargine therapy was 9.3% (7.011.7%), compared to 9.2% in the detemir group (7.413.1%). The median BMI-SDS in the glargine group was 0.9 (−1.4 to +3.1), and in the detemir group was 0.8 (−1.4 to +2.5). After 12 months, the median HbA1C change in the glargine group was −0.35% (−1.5 to 2.3%) compared to +0.9% (−1.5 to 3.3%) in the detemir group (P=NS). The BMI-SDS change was −0.04 (−0.74 to +1.27) in the glargine group compared to +0.29 (−0.55 to +0.75) in the detemir group (P=0.02).
Conclusions: Glycaemic control in the two groups treated with insulin glargine or detemir was not significantly different. However the group treated with insulin detemir showed a significant increase in body mass index at 12 months in comparison with the subjects treated with glargine.
05 - 07 Nov 2008
British Society for Paediatric Endocrinology and Diabetes