Insulin degludec in the basal-bolus regimen in children and adolescents w ith type1 diabetes

Abstract

Objective — to comfirm the efficacy and safety of a basal insulin degludec in the basal-bolus regimen in children and adolescents with type 1 diabetes. Material and methods. 47 patients with type 1 diabetes (from 4 to 17 years) with a duration of the disease from 1 month to 13 years were examined. Insulin degludec was initially administered to patients (n=23) at the same dose as insulin glargin. The dose was 20% less in patients who received Human NPH (n=15). For patients with a newly diagnosed type 1 diabetes (n=9), the dose of insulin degludec was calculated as 1/3 or 1/2 of the daily dose of insulin. A correction of the insulin dose was made according to the profile of the glycemia every 5 days. The continuous monitoring of blood glucose «FreeStyle Libre» (Abbott, USA) was used in 23 patients. Results. After six months the glycosylated hemoglobin level decreased from 8.18±0.25% to 7.31±0.19% (p<0.01). The fasting glucose level was 7.22±0.38 mmol/l. The postprandial glycemia levels were 9.28±0.48 mmol/l. Nocturnal glucose level was constant and lower than at the beginning of the study (8.14±0.18 mmol/l, p<0.05). Conclusions. The decrease of glycemia variability and the lower frequency of hypoglycemia is associated with the action of the ultra-long duration of insulin degludec.