Insulin Glargine versus Neutral Protamine Hagedorn Insulin in Young and Preschool Children with Type 1 Diabetes Mellitus

Document Type : Original Article

Authors

Pediatric department, Faculty of Medicine, Ain Shams University

Abstract

Background: Diabetic patients need to maintain tight glycemic control to avoid long term complications. Children need to achieve tight control without the risk of hypoglycemic excursions.
Objective: To assess the safety and efficacy of   insulin   glargine as a basal insulin in   type 1 diabetic children aged 3 to 8 years old in comparison to neutral protamine Hagedorn (NPH) insulin as regards the key parameters of diabetes management and low-grade inflammation.
Patients and Methods: Fifty children aged 3-8 years old with type 1 diabetes mellitus following in pediatric diabetes clinic, Ain Shams University Hospital were enrolled in this study. They were randomized into two groups, group A: shifted from NPH insulin to basal-bolus regimen using insulin glargine once a day and group B: kept on using NPH insulin two to three times a day. Both used regular insulin or rapid acting analogues at mealtime.
Results: At six months, weight gain was significantly higher among group B patients 0.6 kg (±0.14 SD) vs 0.38 kg, mean fasting blood sugar was lower in group A, 109.1(+17) mg/dl versus 125.3(+20) mg/dl in group B. HbA1C showed significant improvement in both groups with tight control, however group A was better with a mean of 6.7(+0.5)% versus 7.4(+0.7) and still with significantly less hypoglycemic excursions. Hs-CRP as a marker of inflammation showed significant drop with better overall control independent of the basal insulin used.
Conclusion: Insulin glargine as once daily basal insulin is safe in achieving good glycemic control in young and preschool children with less hypoglycemic excursions.
 

Keywords

The Egyptian Journal of Hospital Medicine
Volume 85, Issue 1
October 2021
Pages 2730-2733

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