부산대학교 도서관

The long-acting insulin analog detemir provides basal insulin needs and has the advantage of a more predictable action profile than NPH insulin. Detemir has been shown to achieve an improved balance between glycemic control and risk of hypoglycemia compared with NPH. The aim of this retrospective analysis was to evaluate the impact upon efficacy and tolerability over a 9-month period of switching the basal component of insulin therapy to detemir in children. This is an interim report of 3-month data. Children with type 1 diabetes (N=71, mean age 10.9 years) using basalbolus insulin regimens were switched to insulin detemir once-daily. The following measures were used to assess glycemic control at baseline and 3 months: HbA[sub 1c], fasting plasma glucose (FPG), major hypoglycemic events, basal insulin dose, and total daily insulin dose. HbA[sub 1c] significantly improved from 7.1% at baseline to 6.6% at 3 months (p<0.001). Also, FPG levels significantly improved from 9.6 mmol/L at baseline to 7.5 mmol/L at 3 months (p<0.0001). One major hypoglycemic event occurred during the study period. Detemir insulin dose at baseline (0.25 U/kg) was similar to the insulin dose of the children's previous regimen (0.26 U/kg, ns), and increased slightly by 3 months (0.27 U/kg, p<0.05), as did total daily insulin dose (0.80 U/kg at baseline and 0.83 U/kg at 3 months, p<0.01). Insulin detemir effectively reduced HbA[sub 1c] and FPG levels, and provided good glycemic control in children over a 3-month treatment period. Furthermore, the risk of major hypoglycemic events was low. Insulin detemir therefore appears to be a suitable treatment for children with the potential to improve glycemic control compared with NPH, without compromising tolerability. [ABSTRACT FROM AUTHOR]