Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon

Backgraund: Children with type 1 diabetes mellitus (T1DM) need more insulin late in the evening (reverse dawn phenomenon (RDP)), and adolescents need more insulin yearly in the morning (dawn phenomenon (DP)); these cause blood glucose variability. Modern long acting insulin analogues allow to achiev...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	A. V. Vitebskaya, E. V. Shreder, A. V. Popovich, E. A. Pisareva
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2021
Materias:	type 1 diabetes mellitus children adolescents blood glucose hyperglycemia long acting insulin Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/8bdb00b969054838846ebac90b50d87d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8bdb00b969054838846ebac90b50d87d
record_format	dspace
spelling	oai:doaj.org-article:8bdb00b969054838846ebac90b50d87d2021-11-14T09:00:23ZRetrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon2072-03512072-037810.14341/DM12431https://doaj.org/article/8bdb00b969054838846ebac90b50d87d2021-11-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/12431https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378Backgraund: Children with type 1 diabetes mellitus (T1DM) need more insulin late in the evening (reverse dawn phenomenon (RDP)), and adolescents need more insulin yearly in the morning (dawn phenomenon (DP)); these cause blood glucose variability. Modern long acting insulin analogues allow to achieve satisfactory glycemic control.Aims: To study the characteristics of insulin therapy in children and adolescents with T1DM using insulin analogues detemir and degludec to overcome blood glucose variability caused by DP and RDP in different age periods.Materials and methods: We analyzed medical documents of 200 patients using detemir, admitted to pediatric endocrinology department in 2013–2019, at mean age 9.0 years (5.4; 13.0), with T1DM for 1.3 years (0.5; 3.0); and medical documents of 50 patients switched to degludec in 2018–2019 at mean age 12.0 years (10.5; 14.5) with T1DM for 3.0 years (1.5; 6.0). Before degludec they were on intensive insulin therapy with glargine (22), detemir (26), or insulin pump (2); 16 patients (32%) presented with clinical characteristics of DP, and 5 (10%) — RDP.Results: 67 children of 108 (62%) aged 1–9 years had redistribution of detemir doses to daytime; 58 adolescents of 92 (63%) aged 10–17 лет — to nighttime. Patients switched to degludec demonstrated decrease in HbA1с from 8.7% (7.8; 9.9) to 8.0% (7.4; 9.0) (р<0.001); fasting blood glucose from 9.8 mmol/l (7.4; 11.7) to 7.7 mmol/l (6.4; 8.6) (р<0.001); within-day variability from 35.2% (31.6; 40.9) to 23.5% (19.7; 28.6) (р<0.001); daily insulin dose from 0.98 U/kg/day (0.82; 1.14) to 0.87 U/kg/day (0.75; 1.07) (р=0.002). Sub-groups of patients with DP and RDP demonstrated decrease in fasting blood glucose (from 11.5 mmol/l (9.8; 13.8) to 7.5 mmol/l (6.6; 9.1) (р<0.001)), and late evening blood glucose (from 11.0 mmol/l (10.2; 11.2) to 8.0 mmol/l (6.7; 9.5) (р= 0.03)) correspondently. Achieved levels of glycemic control did not differ between sub-groups of patients initially using glargine or detemir.Conclusions: Compensation of T1DM may be complicated due to DP and RDP. Switching to degludec allowed to achieve better glycemic control and lowering of blood glucose variability caused by DP and DRP.A. V. VitebskayaE. V. ShrederA. V. PopovichE. A. PisarevaEndocrinology Research Centrearticletype 1 diabetes mellituschildrenadolescentsblood glucosehyperglycemialong acting insulinNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 24, Iss 4, Pp 315-324 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	type 1 diabetes mellitus children adolescents blood glucose hyperglycemia long acting insulin Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	type 1 diabetes mellitus children adolescents blood glucose hyperglycemia long acting insulin Nutritional diseases. Deficiency diseases RC620-627 A. V. Vitebskaya E. V. Shreder A. V. Popovich E. A. Pisareva Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
description	Backgraund: Children with type 1 diabetes mellitus (T1DM) need more insulin late in the evening (reverse dawn phenomenon (RDP)), and adolescents need more insulin yearly in the morning (dawn phenomenon (DP)); these cause blood glucose variability. Modern long acting insulin analogues allow to achieve satisfactory glycemic control.Aims: To study the characteristics of insulin therapy in children and adolescents with T1DM using insulin analogues detemir and degludec to overcome blood glucose variability caused by DP and RDP in different age periods.Materials and methods: We analyzed medical documents of 200 patients using detemir, admitted to pediatric endocrinology department in 2013–2019, at mean age 9.0 years (5.4; 13.0), with T1DM for 1.3 years (0.5; 3.0); and medical documents of 50 patients switched to degludec in 2018–2019 at mean age 12.0 years (10.5; 14.5) with T1DM for 3.0 years (1.5; 6.0). Before degludec they were on intensive insulin therapy with glargine (22), detemir (26), or insulin pump (2); 16 patients (32%) presented with clinical characteristics of DP, and 5 (10%) — RDP.Results: 67 children of 108 (62%) aged 1–9 years had redistribution of detemir doses to daytime; 58 adolescents of 92 (63%) aged 10–17 лет — to nighttime. Patients switched to degludec demonstrated decrease in HbA1с from 8.7% (7.8; 9.9) to 8.0% (7.4; 9.0) (р<0.001); fasting blood glucose from 9.8 mmol/l (7.4; 11.7) to 7.7 mmol/l (6.4; 8.6) (р<0.001); within-day variability from 35.2% (31.6; 40.9) to 23.5% (19.7; 28.6) (р<0.001); daily insulin dose from 0.98 U/kg/day (0.82; 1.14) to 0.87 U/kg/day (0.75; 1.07) (р=0.002). Sub-groups of patients with DP and RDP demonstrated decrease in fasting blood glucose (from 11.5 mmol/l (9.8; 13.8) to 7.5 mmol/l (6.6; 9.1) (р<0.001)), and late evening blood glucose (from 11.0 mmol/l (10.2; 11.2) to 8.0 mmol/l (6.7; 9.5) (р= 0.03)) correspondently. Achieved levels of glycemic control did not differ between sub-groups of patients initially using glargine or detemir.Conclusions: Compensation of T1DM may be complicated due to DP and RDP. Switching to degludec allowed to achieve better glycemic control and lowering of blood glucose variability caused by DP and DRP.
format	article
author	A. V. Vitebskaya E. V. Shreder A. V. Popovich E. A. Pisareva
author_facet	A. V. Vitebskaya E. V. Shreder A. V. Popovich E. A. Pisareva
author_sort	A. V. Vitebskaya
title	Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
title_short	Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
title_full	Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
title_fullStr	Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
title_full_unstemmed	Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
title_sort	retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon
publisher	Endocrinology Research Centre
publishDate	2021
url	https://doaj.org/article/8bdb00b969054838846ebac90b50d87d
work_keys_str_mv	AT avvitebskaya retrospectivetrialoflongactinganaloguesdetemiranddegludecusageinchildrenandadolescentstoovercomeglucosevariabilitycausedbydawnphenomenonandreversedawnphenomenon AT evshreder retrospectivetrialoflongactinganaloguesdetemiranddegludecusageinchildrenandadolescentstoovercomeglucosevariabilitycausedbydawnphenomenonandreversedawnphenomenon AT avpopovich retrospectivetrialoflongactinganaloguesdetemiranddegludecusageinchildrenandadolescentstoovercomeglucosevariabilitycausedbydawnphenomenonandreversedawnphenomenon AT eapisareva retrospectivetrialoflongactinganaloguesdetemiranddegludecusageinchildrenandadolescentstoovercomeglucosevariabilitycausedbydawnphenomenonandreversedawnphenomenon
_version_	1718429475227566080

Retrospective trial of long acting analogues detemir and degludec usage in children and adolescents to overcome glucose variability caused by dawn phenomenon and reverse dawn phenomenon

Ejemplares similares