Usefulness of the Long-acting Insulin Analogue Glargine in Basal-Bolus Therapy for Japanese Children and Adolescents with Type 1 Diabetes Mellitus

Abstract

The aim of this study was to evaluate the efficacy of long-acting insulin analogue glargine (G) changing from NPH in basal-bolus therapy for Japanese children and adolescents with type 1 diabetes mellitus (DM1). Thirty patients (11 M, 19 F) with DM1 aged 13.3 ± 4.5 years were included in the study. Mean fasting blood glucose level was significantly decreased (baseline: 142.5 ± 39.3 vs 127.1 ± 24.0, 129.0 ± 29.1, 121.1 ± 26.0 mg/dl at 3, 6, 12 months, respectively, ρ <0.01), and mean HbAi c was significantly decreased (baseline: 8.06 ± 0.85 vs 7.69 ± 0.89, 7.57 ± 0.93, 7.36 ± 0.95%, at 3, 6, 12 months, respectively, ρ <0.01) after changing to G from NPH. Severe hypoglycemia rarely occurred during the study period. In conclusion, basal-bolus therapy using G resulted in improved overall glycemic control with a low risk of severe hypoglycemia in Japanese pediatric patients with DM1.

Efficacy and safety of switching from insulin glargine to insulin degludec in young people with type 1 diabetes

“…La may contribute to achieving optimal glycemic control with fewer hypoglycemic episodes more effectively than Ra by providing a continual background level of insulin [8]. Insulin glargine (IGlar) has long been widely used as the main form of La, and reportedly lasts for up to 24 hours, though a waning effect can be seen at approximately 20 hours after the injection [9].…”

“…Insulin glargine (IGlar) has long been widely used as the main form of La, and reportedly lasts for up to 24 hours, though a waning effect can be seen at approximately 20 hours after the injection [9]. Approximately 70-80% of patients using IGlar give themselves a once-daily injection, whereas others require twice-daily injections to cover their 24-hour basal insulin supplementation [8][9][10][11]. Patients requiring twice-daily injections of basal insulin tend to need a higher dose of insulin to attain optimal glycemic targets, and experience more frequent episodes of hypoglycemia [8,10].…”

“…Approximately 70-80% of patients using IGlar give themselves a once-daily injection, whereas others require twice-daily injections to cover their 24-hour basal insulin supplementation [8][9][10][11]. Patients requiring twice-daily injections of basal insulin tend to need a higher dose of insulin to attain optimal glycemic targets, and experience more frequent episodes of hypoglycemia [8,10]. Recently, insulin degludec (IDeg, Novo Nordisk, Bagsvaerd, Denmark), a new generation ultra-long acting insulin analogue, has become available in the European Union, Japan, and other countries.…”

Association between Sex, Age, Insulin Regimens and Glycemic Control in Children and Adolescents with Type 1 Diabetes

“…Moreover, use of continuous subcutaneous insulin infusion (CSII) has been extended to those in whom MDI is either impractical or ineffective. These measures have been reported to improve hyperglycemia with reducing the occurrence of severe hypoglycemia in the young patients (1,2,3,4). On the other hand, the International Society for Pediatric and Adolescent Diabetes (ISPAD) recommends a target range for HbA1c of less than 7.5% in pediatric patients of all ages with T1DM in its Clinical Practice Consensus Guidelines (5).…”

Insulin glargine in pediatric patients with type 1 diabetes in Japan

“…Moreover, similar results were reported in Japanese children and adolescents with type 1 diabetes. After changing from NPH to glargine, the average HbA1c significantly decreased from 8.06 ± 0.85% to 7.36 ± 0.95% ( P < 0.01), and FPG significantly decreased from 142.5 ± 39.3 mg/dL to 121.1 ± 26.0 mg/dL ( P < 0.01) at 12 months …”