This case series compared the efficacy of long acting basal Insulin, Insulin Degludec compared to Insulin Glargine in adolescent paediatric patients. There were seven patients in total aged 14 to 18 years. Changes in HbA1c, BMI and reduction in nocturnal hypoglycaemic episodes were compared in all seven patients. Insulin Degludec showed a decrease in HbA1C levels, particularly in patients who had HbA1C higher than 48 mmol/mol on Insulin Glargine. There was a 2.4% decrease in HbA1C. Insulin Degludec showed good effect in maintaining BMI compared to Insulin Glargine in patients above the 50th centile for BMI, while showing a small but significant increase in BMI in patients who were below the 50th centile. Insulin Degludecs effects on nocturnal hypoglycaemic episodes varied depending on prior glycaemic control on Insulin Glargine. Patients with poor control on Insulin Glargine showed a significant reduction in nocturnal hypoglycaemic episodes. This case series demonstrates noninferiority of Insulin Degludec compared to Insulin Glargine in improving glycaemic control, but could be considered in patients who have issues with compliance and poor control on insulin Glargine which may lead to nocturnal hypoglycaemias and also adolescentswho have issues with BMI, especially those with BMI above the 50th centile.
22 - 24 Nov 2017
British Society for Paediatric Endocrinology and Diabetes