Ultra long-acting degludec versus long-acting insulin glargine in children and teenagers with type 1 diabetes

Objectives: Unstable metabolic control and frequent hypoglycemic
events are the main indications of switching from long-acting insulin
glargine to ultra long-acting insulin degludec. The aim of the present
study is to evaluate the efficacy of such a switch in children and
adolescents.
Methods: We enrolled retrospectively 58 children and adolescents
with type 1 diabetes divided into two groups matched for age, sex
and metabolic control. Group A was switched from glargine to degludec
while group B continued treatment with glargine. We compared
HbA1c, percent of BG detections below 60 mg/dl, mean and SD of
home blood glucose monitoring (HBGM), HBGI and LBGI during the
three months before and after switching from one to the other insulin
in group A and during the corresponding period in group B. Data
are reported as median (IQR). Chi square and Mann–Whitney test
were used for statistical analysis.
Results: During the three months after switching the percentage of
patients who improved the HbA1c was higher in group A then in
group B. We didn’t find any statistical significant difference between
the two groups for any parameter taken into account. In particular
group A didn’t showed any statistically significant reduction of hypoglycemic
events after switching (see table).
Conclusions: According to our preliminary results the transition from
long-acting insulin glargine to insulin ultra long-acting degludec in
pediatric patients with T1DM does not seem to be able to significantly
improve the metabolic control and reduce the risk of
hypoglycemia.