Long-term Improvement of Fasting Glycaemia after Switching Basal Insulin from NPH to Determir in Children with Type 1 Diabetes: A 1-Year Multicentre Study
Abstract
Background. Paper presents an evaluation of diabetes control after switching from NPH insulin to detemir in children with type 1 diabetes.
Methods and Results. We performed a non-randomized, observational, multicentre study on the first group of children whose treatment switched from NPH to insulin detemir in four centers of paediatric diabetes.
A total of 72 children (39 boys and 33 girls) were included in the analysis. The average age at intervention was 10.6 +- 4.7 yrs, the average age at diabetes onset was 6.2 +- 4.3 yrs.
Diabetes control was assessed 3 months prior to the switch and subsequently during 3-month intervals. Results: Mean HbA1c decreased from 6.9% at baseline to 6.4% after 3 months of detemir therapy (p = 0.0003).
However, in the next months we observed a trend for increasing the HbA1c, and no statistically significant difference in HbA1c was observed at the 6, 9 and 12 months visits vs. baseline. Fasting glycaemia decreased significantly after 3 months of treatment with detemir in comparison with the baseline (the mean value of the difference was 2.1 mmol/l, CI 95% 1.5-2.6, p = 1.4*10-10), and this effect was detectable during all the observational period (month 12 vs. baseline 2.6 mmol/l, p < 10-8).
Conclusions. Switching basal insulin from NPH insulin to detemir resulted in a short-term improvement of HbA1c, and a long-term decreasing of fasting glycaemia.