Introduction: Use of degludec [tresiba] in children and adolescents with type 1 diabetes was approved by EC 2015 and FDA in December 2016. Degludec is a new ultra-long acting basal insulin with terminal half-life of approximately 25 hours and duration of action of more than 42 hours. Constant release of insulin throughout the day leads to better control of blood glucose for more than 24 hours with significant reduction in HbA1c.
Aim: To compare and assess HbA1C control before and after starting degludec.
Methods: We did retrospective case notes review of 24 children over a period of 4 months from October 2016 to January 2017. We have assessed the quality of glycemic control before and after starting degludec in our unit. We also looked at the hospital admission with hypoglycemia or DKA and changes in the insulin dose, basal insulin requirement after starting degludec.
Results: Sex distribution in our study was 54% boys and 46% girls. Majority age group between 11 and 18 yours. 58% were used Glargine and 42% used insulin pump before starting degludec. HbA1c was improved in 62%, static in 13% and worsened in 25% of our patients. Four patients had DKA before starting degludec. In these four patients, three were using pump with missing boluses causing poor control requiring admission with DKA, which was improved after starting degludec. Two patients needed hospital admission with hypoglycemia after starting degludec. 67% patients needed less basal insulin after starting degludec. We have also noted documentation about reason and patient perception after starting degludec. Main reason for starting degludec as documented in case notes was for better glycemic control. Few patients (4) reported that injecting degludec was less painful and provided more flexibility.
Conclusion: Our study showed better glycemic control after starting degludec in our unit and also less admission with DKA.
22 - 24 Nov 2017
British Society for Paediatric Endocrinology and Diabetes