Background: Paper presents an evaluation of diabetes control after switching from NPH insulin to detemir in children with type 1 diabetes.
Methods and results: We performed a non-randomized, observational, multicentre study on the first group of children whose treatment switched from NPH to insulin detemir in four centers of paediatric diabetes. A total of 72 children (39 boys and 33 girls) were included in the analysis. The average age at intervention was 10.6 +/- 4.7 yrs, the average age at diabetes onset was 6.2 +/- 4.3 yrs. Diabetes control was assessed 3 months prior to the switch and subsequently during 3-month intervals.
Results: Mean HbA(1c) decreased from 6.9% at baseline to 6.4% after 3 months of detemir therapy (p = 0.0003). However, in the next months we observed a trend for increasing the HbA(1c), and no statistically significant difference in HbA(1c) was observed at the 6, 9 and 12 months visits vs. baseline. Fasting glycaemia decreased significantly after 3 months of treatment with detemir in comparison with the baseline (the mean value of the difference was 2.1 mmol/l, CI 95% 1.5-2.6, p = 1.4*10(-10)), and this effect was detectable during all the observational period (month 12 vs. baseline 2.6 mmol/l, p < 10(-8)).
Conclusions: Switching basal insulin from NPH insulin to detemir resulted in a short-term improvement of HbA(1c), and a long-term decreasing of fasting glycaemia.