Objective: The advantages of continuous subcutaneous insulin infusion (CSII) or insulin glargine have been demonstrated both in adult and paediatric diabetic patients; however, as no data comparing these two approaches during childhood are available, we have examined the efficacy of these two intensive approaches. Research design and methods: We retrospectively evaluated data from 36 diabetic children, who had changed their previous insulin regimen [with isophane insulin (NPH) at bedtime] because of HbA 1c levels >8.0%. Twenty patients underwent CSII, while the other 16 (significantly younger for age) started insulin glargine at bedtime. Results: At 6 and 12 months, CSII-treated patients showed a significant reduction in HbA 1c values from 8.5 ± 1.8 to 7.4 ± 1.1% and to 7.6 ± 1.2%, respectively. The insulin requirement significantly decreased from 0.93 ± 0.2 IU/kg to 0.73 ± 0.2 IU/kg of body weight and to 0.74 ± 0.15 IU/kg of body weight, respectively, while no significant differences were observed for BMI SDS, fructosamine and severe hypoglycaemic events. The patients treated with glargine showed a small decline in HbA 1c values from 8.9 ± 1.7 to 8.3 ± 0.9% (not significant) in the first 6 months of treatment and to 8.2 ± 0.9% after 12 months. Conclusion: The basal insulin supplementation can be supplied effectively in children with type 1 diabetes by either CSII or insulin glargine. As previously reported for adults, it is confirmed that CSII is the best current intensive approach aimed to the improvement of glycaemic control.
- Basal insulin supplementation
- Insulin Glargine
- Type 1 diabetes
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism