Dündar Bumin Nuri, Dündar Nihal, Eren Erdal
Department of Pediatric Endocrinology, Süleyman Demirel University, Faculty of Medicine, Isparta, Turkey.
J Clin Res Pediatr Endocrinol. 2009;1(4):181-7. doi: 10.4274/jcrpe.v1i4.56. Epub 2009 May 4.
The purpose of this study was to compare the efficacy and safety of insulin glargine and detemir with NPH insulin in children and adolescents with type 1 diabetes mellitus (DM).
Thirty four children and adolescents with type 1 DM (mean age 12.7 ± 3.4 years, diabetes duration 5.4 ± 3.0 years) were included in the study. All patients had been receiving intensive insulin therapy with insulin aspart and NPH for at least 6 months before switching from NPH to insulin glargine (Group 1, n=19) or detemir (Group 2, n=15). The medical records obtained within 6 months before and after treatment with insulin glargine and detemir were retrospectively reviewed and the data were compared in each group.
The mean age and duration of DM were similar in two groups (p>0.05). In both groups, switching from NPH to insulin glargine or detemir, resulted in a reduction in HbA(1c) (p0.05, for both). Patients in the detemir treated group had less increment in body mass index (BMI) SDS at the end of 6 months of therapy compared to NPH and glargine treated patients (p>0.05, for both). No side effects were noted throughout the study.
Both insulin glargine and detemir improved HbA(1c) at short-term and proved to be safe and well tolerated in children and adolescents with type 1 DM.
本研究旨在比较甘精胰岛素和地特胰岛素与中性鱼精蛋白锌胰岛素（NPH胰岛素）在1型糖尿病儿童及青少年中的疗效和安全性。
34例1型糖尿病儿童及青少年（平均年龄12.7±3.4岁，糖尿病病程5.4±3.0年）纳入本研究。所有患者在从NPH胰岛素转换为甘精胰岛素（1组，n=19）或地特胰岛素（2组，n=15）之前，均已接受门冬胰岛素和NPH胰岛素强化治疗至少6个月。回顾性分析甘精胰岛素和地特胰岛素治疗前后6个月内的病历，并对每组数据进行比较。
两组患者的平均年龄和糖尿病病程相似（p>0.05）。两组中，从NPH胰岛素转换为甘精胰岛素或地特胰岛素后，糖化血红蛋白（HbA1c）均降低（两者p均<0.05）。与NPH胰岛素和甘精胰岛素治疗的患者相比，地特胰岛素治疗组患者在治疗6个月末体重指数（BMI）标准差评分的增加较少（两者p>0.05）。在整个研究过程中未观察到副作用。
甘精胰岛素和地特胰岛素在短期内均改善了HbA1c，且在1型糖尿病儿童及青少年中被证明是安全且耐受性良好的。
