ESPE Abstracts

Objective of the study: Comparative assessment of the achievement of target levels of the therapy for type 1 diabetes mellitus using various types of insulin in an outpatient setting.

Materials and methods: The study included 100 children and adolescents with type 1 diabetes aged 4–17 years old who received basic insulin Glargin and Insulatard, and short-acting Glilusin and Actrapid. Of these, 50 children and adolescents were switched to Glargine once in the morning before breakfast (basis), injections of simple ultra-short-acting insulin (Glilusin) two to three times a day immediately before meal.

Clinical characteristics of the patients

Physical development, biochemical parameters (HbA1c, creatinine, cholesterol), daily dose and insulin requirement, frequency of acute and chronic complications were assessed in dynamics.

Research results: In the group receiving Glargine + Glilusin, there was an increase in height by 3.9%, weight by 14.4%, and in the group receiving Insulatard + Actrapid, growth increased by 3.2%, and weight by 11.8%. To achieve compensation in both groups, it was necessary to increase the doses of daily insulin, but within 12 months the need for insulin in the Glargine group was less and amounted to 1.0 U/kg, and in the Insulatard group it was 1.1 U/kg. The daily dose of Glargine was 5.7 units less than the dose of Insulatard. Comparative analysis of the use of various types of insulin showed that patients receiving insulin glargine achieved lower levels of HbA1c (7.4 ± 0.2%) compared with the children receiving conventional genetically engineered insulins (HbA1c 8.0 ±0.2%). The proportion of patients with HbA1c levels below 7.5% transferred to Glargine therapy increased from 11.7% to 53%, and in the group receiving Insulatard from 5.8% to 29.4%.

Conclusions: 1) During the monitoring period, there was a greater extent improvement in height and weight indicators in the children and adolescents in the Glargin + Glilusin group. 2) Together with the background intensified insulin therapy with Insulatard, there was 1.5% decrease in HbA1c, and 1.6% with Glargine. Target levels of glycemia in the Glargine group were achieved with the background lower dose requirement. 3) The average daily dose increased by 20% with Glargine and by 14% with Insulatard.