Razzaghy-Azar Maryam, Momeni Hosein, Nourbakhsh Mona, Nourbakhsh Mitra, Talebi Atefeh, Pourgholi Gholamreza, Zeinolabedinian Fahimeh
Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2021 Summer;20(3):647-653. doi: 10.22037/ijpr.2021.114841.15059.
The aim of this study was to compare the insulin glargine and detemir effects on hormons affecting appetite and metabolic control of patients with type 1 diabetes. This single-blind randomized clinical trial was conducted on patients aged 2 to 18 years with type 1 diabetes who were referred to the endocrinology department of Ali-Asghar Children Hospital in Tehran, from April to September 2019. Patients were randomly allocated to receive insulin Glargine or insulin Detemir. Before starting treatment, blood samples were obtained for routine biochemical tests and factors affecting appetite, including Leptin, Ghrelin, Aguti-Related Peptide (AGRP), and Peptide-YY3-36 (PYY 3-36). Patients were evaluated monthly and insulin dose was adjusted based on target glucose and carbohydrate counting. At the end of three months, the anthropometric values , HbA1C and factors that influence appetite were measured again in both groups, and the results were compared. A total of 40 children with a new onset of type 1 diabetes under 18 years who were hospitalized in Ali Asghar Children Hospital were randomly assigned into two groups as Glargine (n = 20) and Detemir (n = 20). The mean age of patients in the Glargine group was 11.07 ±4.18 years and in the Detemir group was 8.06 ± 3.56. In Glargine group HbA1C, Cholesterol, LDL, AGRP significantly decreased and leptin increased after treatment., while the change of BMI Z-score was not significant. There was a significant decrease of HbA1C in the Detemir group after treatment but there was no significant change of other variables. There was no significant difference for all the variables between two groups after treatment. There was no significant difference for BMI, metabolic control and appetite hormones between Glargine and Detemir groups. BMI-z score did not change in Glargine group while leptin increased and AGRP decreased after treatment. HbA1C decreased significantly after treatment in both groups.
本研究的目的是比较甘精胰岛素和地特胰岛素对1型糖尿病患者影响食欲和代谢控制的激素的作用。这项单盲随机临床试验于2019年4月至9月在德黑兰阿里 - 阿斯加尔儿童医院内分泌科就诊的2至18岁1型糖尿病患者中进行。患者被随机分配接受甘精胰岛素或地特胰岛素治疗。在开始治疗前，采集血样进行常规生化检测以及检测影响食欲的因子，包括瘦素、胃饥饿素、刺鼠相关肽（AGRP）和肽YY3-36（PYY 3-36）。患者每月接受评估，并根据目标血糖和碳水化合物计数调整胰岛素剂量。在三个月结束时，再次测量两组患者的人体测量值、糖化血红蛋白（HbA1C）以及影响食欲的因子，并比较结果。共有40名18岁以下新诊断为1型糖尿病且在阿里 - 阿斯加尔儿童医院住院的儿童被随机分为两组，甘精胰岛素组（n = 20）和地特胰岛素组（n = 20）。甘精胰岛素组患者的平均年龄为11.07±4.18岁，地特胰岛素组为8.06±3.56岁。甘精胰岛素组治疗后糖化血红蛋白、胆固醇、低密度脂蛋白、AGRP显著降低，瘦素升高，而体重指数Z评分变化不显著。地特胰岛素组治疗后糖化血红蛋白显著降低，但其他变量无显著变化。治疗后两组所有变量之间均无显著差异。甘精胰岛素组和地特胰岛素组在体重指数、代谢控制和食欲激素方面无显著差异。甘精胰岛素组体重指数Z评分未变化，治疗后瘦素升高，AGRP降低。两组治疗后糖化血红蛋白均显著降低。
