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Treatment with insulin glargine reduces asymptomatic hypoglycemia detected by continuous subcutaneous glucose monitoring in children and adolescents with type 1 diabetes.
Pediatr Diabetes. 2007 Jun; 8(3):157-62.PD

Abstract

OBJECTIVE

Unsatisfactory basal insulin substitution may lead to asymptomatic hypoglycemia in children and adolescents with type 1 diabetes (T1D). To investigate the effects of multiple daily injections before and after changing to insulin glargine (IG), continuous glucose monitoring system (CGMS) data were used to analyze glycemic control and hypoglycemic episodes during the two different therapy regimens.

METHODS

Basal insulin therapy was changed to one daily injection of IG in 30 pediatric patients with T1D (14 boys and 16 girls; age 4.5-18.3 yr, median 14.2 yr; diabetes duration 0.5-15.6 yr, median 4.6 yr) having elevated fasting glucose or recurrent hypoglycemia despite treatment with multiple injection therapy (basal insulin: two to four injections of neutral protamine Hagedorn (NPH) and/or zinc lente insulin). Ambulatory CGMS was applied before and 6-8 wk after treatment change. Frequency of hypoglycemic and hyperglycemic episodes, glucose area under the curve (AUC), and time below 60 mg/dL and above 180 mg/dL, respectively, were calculated from CGMS data during the day (8:00-22:00 hours) and at night (22:00-8:00 hours).

RESULTS

Nocturnal hypoglycemia was detected by CGMS in 20 patients before and in 12 patients after the change to IG (p = .039), whereas both, the number of nocturnal and diurnal hypoglycemic episodes, decreased not significantly from 41 to 36 (p = .758) and 48 to 28 (p = .055), respectively. AUC and time below 60 mg/dL as well as hemoglobin A1c (HbA1c) were not significantly different before and after the change to IG.

CONCLUSION

Under treatment with IG, asymptomatic hypoglycemia was reduced without increase of HbA1c.

Authors+Show Affiliations

Clinic of General Pediatrics, Otto-Heubner-Centrum, Charité, Campus Virchow-Klinikum, Humboldt University, Berlin, Germany. dorothee.deiss@charite.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17550426

Citation

Deiss, Dorothee, et al. "Treatment With Insulin Glargine Reduces Asymptomatic Hypoglycemia Detected By Continuous Subcutaneous Glucose Monitoring in Children and Adolescents With Type 1 Diabetes." Pediatric Diabetes, vol. 8, no. 3, 2007, pp. 157-62.
Deiss D, Kordonouri O, Hartmann R, et al. Treatment with insulin glargine reduces asymptomatic hypoglycemia detected by continuous subcutaneous glucose monitoring in children and adolescents with type 1 diabetes. Pediatr Diabetes. 2007;8(3):157-62.
Deiss, D., Kordonouri, O., Hartmann, R., Hopfenmüller, W., Lüpke, K., & Danne, T. (2007). Treatment with insulin glargine reduces asymptomatic hypoglycemia detected by continuous subcutaneous glucose monitoring in children and adolescents with type 1 diabetes. Pediatric Diabetes, 8(3), 157-62.
Deiss D, et al. Treatment With Insulin Glargine Reduces Asymptomatic Hypoglycemia Detected By Continuous Subcutaneous Glucose Monitoring in Children and Adolescents With Type 1 Diabetes. Pediatr Diabetes. 2007;8(3):157-62. PubMed PMID: 17550426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment with insulin glargine reduces asymptomatic hypoglycemia detected by continuous subcutaneous glucose monitoring in children and adolescents with type 1 diabetes. AU - Deiss,Dorothee, AU - Kordonouri,Olga, AU - Hartmann,Reinhard, AU - Hopfenmüller,Werner, AU - Lüpke,Kerstin, AU - Danne,Thomas, PY - 2007/6/7/pubmed PY - 2007/9/13/medline PY - 2007/6/7/entrez SP - 157 EP - 62 JF - Pediatric diabetes JO - Pediatr Diabetes VL - 8 IS - 3 N2 - OBJECTIVE: Unsatisfactory basal insulin substitution may lead to asymptomatic hypoglycemia in children and adolescents with type 1 diabetes (T1D). To investigate the effects of multiple daily injections before and after changing to insulin glargine (IG), continuous glucose monitoring system (CGMS) data were used to analyze glycemic control and hypoglycemic episodes during the two different therapy regimens. METHODS: Basal insulin therapy was changed to one daily injection of IG in 30 pediatric patients with T1D (14 boys and 16 girls; age 4.5-18.3 yr, median 14.2 yr; diabetes duration 0.5-15.6 yr, median 4.6 yr) having elevated fasting glucose or recurrent hypoglycemia despite treatment with multiple injection therapy (basal insulin: two to four injections of neutral protamine Hagedorn (NPH) and/or zinc lente insulin). Ambulatory CGMS was applied before and 6-8 wk after treatment change. Frequency of hypoglycemic and hyperglycemic episodes, glucose area under the curve (AUC), and time below 60 mg/dL and above 180 mg/dL, respectively, were calculated from CGMS data during the day (8:00-22:00 hours) and at night (22:00-8:00 hours). RESULTS: Nocturnal hypoglycemia was detected by CGMS in 20 patients before and in 12 patients after the change to IG (p = .039), whereas both, the number of nocturnal and diurnal hypoglycemic episodes, decreased not significantly from 41 to 36 (p = .758) and 48 to 28 (p = .055), respectively. AUC and time below 60 mg/dL as well as hemoglobin A1c (HbA1c) were not significantly different before and after the change to IG. CONCLUSION: Under treatment with IG, asymptomatic hypoglycemia was reduced without increase of HbA1c. SN - 1399-543X UR - https://www.unboundmedicine.com/medline/citation/17550426/Treatment_with_insulin_glargine_reduces_asymptomatic_hypoglycemia_detected_by_continuous_subcutaneous_glucose_monitoring_in_children_and_adolescents_with_type_1_diabetes_ L2 - https://doi.org/10.1111/j.1399-5448.2007.00252.x DB - PRIME DP - Unbound Medicine ER -