Detemir: Role in Type 1 Diabetes
Detemir: Role in Type 1 Diabetes
Study of blood sugars in the children with Type 1 Diabetes Mellitus (T1DM), who are given
 insulin detemir and a rapid acting insulin (aspart). It is hypothesized that there is no
 difference in the patterns of blood sugars when detemir is given in the same syringe or in
 separate syringes with rapid acting insulin.
One of the barriers to good glycemic control in children with type 1 diabetes is multiple
 daily insulin injections. Mixing rapid-acting (detemir) and slow- acting insulins (aspart) in
 the same syringe would decrease the number of injections and may improve adherence

 This study hypothesized that slow-acting insulin detemir mixed with aspart would have
 equivalent effects on blood glucose versus giving them as separate injections in children
 with type 1 diabetes.

 Eighteen pediatric subjects with type 1 diabetes (11 males and 7 females) were recruited.
 However only 14 subjects completed this 20-day, randomized, crossover, and open-labeled
 study. The subjects were randomly assigned to either Study A (both insulin detemir and rapid
 acting insulin (RAI)) or Study B (either detemir or aspart) for the first 10 days. They were
 then crossed over for the last 10 days. Each subject underwent 72 h of continuous glucose
 monitoring (CGM) during the last 72 h, for both Study A and Study B.Data of 48 h from
 midnight of the 1st day to mid- night of the 3rd day of the 72-h (CGM) were used for analysis
 to ensure the same starting and ending times of monitoring for all subjects.Sustained glucose
 values over time were calculated as area under the curve (AUC), index of blood glucose
 control as M-value and glucose excursion as mean amplitude of glucose excursion (MAGE)
Inclusion Criteria:

 -  Subjects with antibody positive Type 1 Diabetes Mellitus (T1DM)

 -  On insulin glargine for at least 3 months

 -  Age 10-25 years

 -  Not on medications that may affect glucose concentrations

 -  Hemoglobin A1C (HbA1C) of less than 9 %

 -  Body Mass Index (BMI) less than 95th % and more than 10th%

 -  Supportive family

 Exclusion Criteria:

 -  Subjects with undetermined diabetes or Type 2 Diabetes Mellitus (T2DM)

 -  Unable to adhere to insulin regimen

 -  Positive urine pregnancy test