Effect of Insulin Glargine in Adolescents with Uncontrolled type 1 Diabetes Mellitus

Lee, Yeoun Joo; Ko, Jung Min; Yoo, Han Wook

Abstract

PURPOSE: With long acting time of 24 hours and no peak concentration, insulin glargine (Lantus(R), Aventis Pharma, Frankfurt, Germany) is preferably used as basal insulin to control fasting glucose level. The study was undertaken to evaluate the effect of insulin glargine as a basal insulin of intensive insulin therapy in uncontrolled type 1 diabetic adolescent patients.
METHODS
The subject included 47 uncontrolled type 1 diabetic patients who have been treated by NPH and RI or insulin lispro. They were followed up for the mean duration of 7.2 months. Clinical parameters including treatment duration, fasting plasma glucose, glycosylated hemoglobin, total insulin doses, body weight, and body mass index were analyzed and compared before and after introduction of insulin glargine therapy. Mean age was 16.0+/-2.8 years old.
RESULTS
Glycosylated hemoglobin was significantly decreased (9.4+/-1.4% to 8.6+/-1.4%, P<0.001) and fasting blood glucose level was also significantly decreased (182.6+/-53.2 mg/dL to 129.1+/-52.3 mg/dL, P<0.001, n=18) after switching to insulin glargine. Body weight increased significantly (56.4+/-9.4 kg to 57.9+/-9.6 kg, P=0.022) but increment of both total insulin dose (1.03+/-0.32 unit/kg/day to 1.04+/-0.29 unit/kg/day) and body mass index were insignificant. The mean dose of insulin glargine was 0.42+/-0.13 unit/kg/day.
CONCLUSION
Insulin glargine as a basal insulin of intensive insulin therapy is more efficacious in diabetic control in adolescents with uncontrolled type 1 diabetes mellitus than conventional insulin therapy. Long-term follow up is needed for evaluating the effect of insulin glargine on diabetic control, prevention of hypoglycemia, and complication.