Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues

Background/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and...

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Main Authors: Plavšić Ljiljana, Mitrović Katarina, Todorović Slađana, Vuković Rade, Milenković Tatjana, Zdravković Dragan
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2014-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501400039P.pdf
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author Plavšić Ljiljana
Mitrović Katarina
Todorović Slađana
Vuković Rade
Milenković Tatjana
Zdravković Dragan
author_facet Plavšić Ljiljana
Mitrović Katarina
Todorović Slađana
Vuković Rade
Milenković Tatjana
Zdravković Dragan
author_sort Plavšić Ljiljana
collection DOAJ
description Background/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurrence of hypoglycaemic episodes in children and adolescents with T1DM. Methods. The study group consisted of 151 children and adolescents (90 boys, 61 girls) treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7%) patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA), and the group II of 79 (52.3%) patients treated with a combination of rapid-acting and long-acting analogue (RA/LA). The levels of glycated hemoglobin (HbA1c) and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. Results. The mean HbA1c was significantly lower in the group I (RHI/LA) after 6 months (9.15% vs 8.20%, p < 0.001) and after 12 months (9.15% vs 8.13%, p < 0.001) as well as in the group II (RA/LA) after 6 months (9.40% vs 8.24%, p < 0.001) and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001). The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001), and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001). Conclusion. Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.
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spelling doaj-art-b9ef849449564bb18ade06ceb91c10602025-08-20T02:18:57ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502014-01-0171981782010.2298/VSP130422039P0042-84501400039PGlycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analoguesPlavšić Ljiljana0Mitrović Katarina1Todorović Slađana2Vuković Rade3Milenković Tatjana4Zdravković Dragan5Mother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, SerbiaMother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, SerbiaMother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, SerbiaMother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, SerbiaMother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, SerbiaMother and Child Health Care Institute of Serbia "Dr Vukan Čupić", Belgrade, Serbia + University in Belgrade, Faculty of Medicine, Belgrade, SerbiaBackground/Aim. An ideal insulin regimen for children and adolescents with type 1 diabetes mellitus (T1DM) should be physiological, flexibile and predictable, protecting against hypoglycaemia. The aim of this study was to evaluate the influence of insulin analogues on glycaemic control and the occurrence of hypoglycaemic episodes in children and adolescents with T1DM. Methods. The study group consisted of 151 children and adolescents (90 boys, 61 girls) treated with human insulins for at least 12 months before introducing insulin analogues. All the patients were divided into two groups: the group I consisted of 72 (47.7%) patients treated with three injections of regular human insulin before meals and long-acting analogue (RHI/LA), and the group II of 79 (52.3%) patients treated with a combination of rapid-acting and long-acting analogue (RA/LA). The levels of glycated hemoglobin (HbA1c) and the number of hypoglycaemic episodes were assessed at the beginning of therapy with insulin analogues, and after 6 and 12 months. Results. The mean HbA1c was significantly lower in the group I (RHI/LA) after 6 months (9.15% vs 8.20%, p < 0.001) and after 12 months (9.15% vs 8.13%, p < 0.001) as well as in the group II (RA/LA) after 6 months (9.40% vs 8.24%, p < 0.001) and after 12 months of insulin analogues treatment (9.40% vs 8.38%, p < 0.001). The frequency of severe hypoglycaemia was significantly lower in both groups after 6 months (in the group I from 61.1% to 4.2% and in the group II from 54.4% to 1.3%, p < 0.001), and after 12 months (in the group I from 61.1% to 1.4% and in the group II from 54.4% to 1.3%, p < 0.001). Conclusion. Significantly better HbA1c values and lower risk of severe hypoglycaemia were established in children and adolescents with T1DM treated with insulin analogues.http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501400039P.pdfdiabetes melitustype 1childadolescenthypoglycemiainsulintreatment outcome
spellingShingle Plavšić Ljiljana
Mitrović Katarina
Todorović Slađana
Vuković Rade
Milenković Tatjana
Zdravković Dragan
Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
Vojnosanitetski Pregled
diabetes melitus
type 1
child
adolescent
hypoglycemia
insulin
treatment outcome
title Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
title_full Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
title_fullStr Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
title_full_unstemmed Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
title_short Glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
title_sort glycaemic control and prevalence of hypoglycaemic events in children and adolescents with type 1 diabetes mellitus treated with insulin analogues
topic diabetes melitus
type 1
child
adolescent
hypoglycemia
insulin
treatment outcome
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2014/0042-84501400039P.pdf
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