Reduced severe and symptomatic hypoglycemic episodes in adolescents with type 1 diabetes using long acting insulin analogs

Abstract EN

Insulin Glargine ( GlyA21-ArgBa30-ArgBb30 ), is a biosynthetic basal insulin analog with a prolonged duration of action ( about 24 hours ) without peaks of plasma insulin levels.

This study evaluated the efficiency and safety of Insulin glargine in subjects with type 1 diabetes compared to NPH, as basal insulin therapy in type 1 diabetes mellitus, regarding the degree of glycemic control (glycosylated Hb & fasting blood glucose), hypoglycemic episodes, required insulin dose and local reactions.

Thirty five Egyptian adolescents with type 1 diabetes were randomized to receive premeal regular insulin and basal insulin, either insulin glargine ( at bedtime ) or NPH Insulin ( Twice daily ) for up to 6 months.

Dose titration of both basal insulins was based on capillary fasting blood glucose( FBG ) levels; the goal was a premeal blood glucose concentration of 80-120 mg / dl.

Results revealed that, both treatment groups (glargine & NPH), were comparable regarding age, diabetes duration, mean FBG, glycosylated Hb (HbA1c %) and required insulin dose, at the start of the study.

Throughout the 6 months study duration, insulin glargine group showed more mean reduction in HbA1c% (2.3%), compared to NPH insulin group (1.4%), however, the difference was statistically insignificant (p=0.28).

Also, there was no significant.

Difference between both groups Reduced Severe And Symptomatic regarding mean change of insulin dose or number of local reactions.

Both types of insulin were comparable regarding total and nocturnal hypoglycemic episodes, however, significantly fewer severe (p = 0.02) and symptomatic (p = 0.03) hypoglycemic episodes occurred in glargine compared to NPH group.

In conclusion, Insulin Glargine once a day appears to be as safe and as effective as NPH insulin twice a day in maintaining glycemic control in patients with type 1 diabetes with less frequent severe and symptomatic hypoglycemia.