Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes
- Neil H. White, MD, CDE1,
- H. Peter Chase, MD2,
- Silva Arslanian, MD3,
- William V. Tamborlane, MD4 and
- for the 4030 Study Group*
- 1Department of Pediatrics and Medicine, Pediatric Patient-Oriented Research Unit, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
- 2Barbara Davis Center, University of Colorado, Aurora, Colorado
- 3Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- 4Department of Pediatrics, Yale Center for Clinical Investigation, Yale University School of Medicine, New Haven, Connecticut
- Corresponding author: Neil H. White, white_n{at}kids.wustl.edu
Abstract
OBJECTIVE—To compare the glucose variability associated with insulin glargine and NPH/Lente insulin used as the basal insulin component of a multiple daily injection (MDI) regimen in pediatric patients with type 1 diabetes.
RESEARCH DESIGN AND METHODS—Continuous glucose monitoring data were collected from a subset of patients (n = 90) who agreed to use a continuous glucose monitoring system during an active-controlled, randomized, open-label study evaluating the safety and efficacy of insulin glargine and NPH/Lente insulin used with insulin lispro as part of an MDI regimen.
RESULTS—Treatment with insulin glargine resulted in significant reductions in glucose variability as measured by the SD of glucose values (adjusted mean change from baseline to week 24: −13.4 mg/dl [−0.74 mmol/l]; P ≤ 0.05), mean amplitude of glycemic excursion (−34.4 mg/dl [−1.91 mmol/l]; P ≤ 0.0001), and M value (−9.6 mg/dl [−0.53 mmol/l]; P ≤ 0.03). The corresponding reductions in glucose variability for NPH/Lente were not significant.
CONCLUSIONS—Insulin glargine is associated with greater reductions in glucose variability than NPH/Lente insulin in pediatric patients with type 1 diabetes.
Footnotes
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↵* A complete list of the members of the 4030 Study Group can be found in the acknowledgments.
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Published ahead of print at http://care.diabetesjournals.org on 23 December 2008.
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- Accepted December 10, 2008.
- Received April 25, 2008.
- DIABETES CARE
