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.