[Use of insulin glargine in type 1 diabetes children with less than eight years old]

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Guilherme Rollin1, Márcia Punales, César Geremia

  • 1Grupo Hospitalar Conceição, Instituto da Criança com Diabetes, Porto Alegre, RS, Brasil.

Arquivos Brasileiros De Endocrinologia E Metabologia
|November 7, 2009
PubMed

Insights

Insulin glargine showed similar metabolic control to NPH insulin in children with type 1 diabetes. However, insulin glargine significantly reduced nocturnal and severe hypoglycemia episodes, indicating a better safety profile.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Pharmacological Safety

Background:

  • Type 1 diabetes mellitus (T1DM) in young children requires careful management of blood glucose levels.
  • Optimizing glycemic control while minimizing hypoglycemia is crucial for long-term health outcomes.
  • Insulin therapy, including basal-bolus regimens, is the cornerstone of T1DM management.

Purpose of the Study:

  • To prospectively assess the efficacy and safety of insulin glargine in children younger than eight years with T1DM.
  • To compare metabolic control (A1C) and hypoglycemia rates between insulin glargine and NPH insulin.

Main Methods:

  • A prospective study involving 30 children (19 boys, 11 girls) with T1DM.
  • Initial 3-month treatment with NPH and aspart insulins, followed by 12 months of insulin glargine and aspart.
  • Self-monitoring of blood glucose (SMBG) at multiple time points, including 3:00 AM.

Main Results:

  • Mean A1C levels remained comparable (8.68% at baseline vs. 8.64% after glargine, p=0.82).
  • Insulin glargine significantly reduced the frequency of mild nocturnal hypoglycemia (0.28/3 months vs. 1.43/3 months, p<0.007).
  • A significant decrease in severe hypoglycemia was observed with insulin glargine (0.008/3 months vs. 0.56/3 months, p<0.002).

Conclusions:

  • Insulin glargine demonstrated comparable efficacy to NPH insulin for metabolic control in young T1DM children.
  • Insulin glargine offered a superior safety profile due to a lower incidence of nocturnal and severe hypoglycemia.
  • Insulin glargine represents a safe and effective option for managing T1DM in prepubertal children.
Abstract

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