Comparative Study of the Effectiveness of Long- and Intermediate-Acting Insulins in Children with Type 1 Diabetes Mellitus

Abstract

chieving glycemic control without risking hypoglycemia imposes a major challenge among young children with type 1 diabetes (T1D). Hence, current study was planned to compare the effectiveness of insulin Degludec to insulin Glargine and NPH insulin among toddlers and preschoolers with T1D in terms of glycosylated hemoglobin (HbA1c) and frequency of hypoglycemic episodes We conducted a randomized-controlled trial including 60 toddlers and preschoolers aged 2-6years newly diagnosed with TID (less than 6 months disease duration) recruited from Pediatric and Adolescents Diabetes Unit (PADU), Children's Hospital, Ain- Shams University during the period June 2018 to November 2020. All included patients were subjected to history taking including age, gender, weight, history of clinically significant hypoglycemia, insulin therapy (dose and type), history of diabetic ketoacidosis, family history, mode of presentation, preceding events and duration. General examination including body weight, height and BMI were measured according to standardized procedures plotted against age and sex corresponding charts also mean HbA1c levels were measured. According to basal insulin they were assigned into three equal groups; insulin Degludec, insulin Glargine and NPH insulin. The three groups were followed-up for 6 months with assessment of insulin daily-dose (IDD), frequency of hypoglycemia and severe hypoglycemia/week and HbA1c. Patient’s ages ranged between 2–6 years with Mean ±SD of 3.53 ± 1.17 years. They were 27 boys (45%), a