Влияние терапии инсулином деглудек на вариабельность гликемии, уровень гликированного гемоглобина и время нахождения параметров в целевом диапазоне у детей с сахарным диабетом 1 типа

Abstract

Study Objective: To compare glycemia variability (GV), glycated hemoglobin (HbA1c) and time in range in paediatric patients with type 1 diabetes mellitus (DM1) with various baseline GV after the change from basal insulin detemir to insulin degludec. Study Design: Non-randomised controlled study. Materials and Methods. We examined 30 children with DM1 aged 5 to 17 years; duration of disease was at least 1 year. Patients were divided into two groups, depending on the rate of the coefficient of variability (CV): ≤ 36% — group 1, > 36% — group 2. Time in range, time above range and time below range as well as CV were evaluated on the basis of the standard outpatient glucose profile using glycemia monitoring programme with periodic scanning (flash monitoring) before and after the change of basal insulin. Study Results. After group 2 patients switched from insulin detemir to insulin degludec, we noted increased time in range (from 40.3 ± 11.5% to 62.4 ± 6.7%; р < 0.001), reduced time above range (from 53.7 ± 10.7% to 34.1 ± 6.6%; р < 0.001), CV (from 43.2 ± 5.4% to 37.0 ± 3.3%; р = 0.05), and HbA1c (from 9.4 ± 1.5% to 7.5 ± 0.7%; р < 0.05), with no time below range. Conclusion. In children with DM1 who were treated with basal insulin detemir and had high GV, switching to insulin degludec allows significant improvement of metabolic control without the risk of hypoglycaemia. Keywords: type 1 diabetes mellitus, glycemia variability, degludec, coefficient of variation, time in range.