Comparison of Efficacy of Detemir and Degludec Insulin in the Management of Children and Adolescents with Type 1 Diabetes

Aims and Objectives: Despite the advantages offered by current basal analogs, the management of type 1 diabetes (T1D) in children and adolescents is a great challenge till now. Insulin degludec (IDeg) is alternative basal insulin to be used in persons not responding to other basal insulins. The aim of the study was to compare the efficacy of IDeg (once daily) and insulin detemir (IDet) in children and adolescents with T1D in Bangladesh. Materials and Methods: In this retrospective analysis, we included T1D patients who were treated with IDet or IDeg in CDiC Diabetes Center, BIRDEM Hospital from January to June 2018. Thirty patients with IDeg were compared with 30 patients who were taking IDet; patients were randomly selected from the data set. Insulin dose requirement, weight, body mass index, fasting plasma glucose (FPG), and HbA1c were compared at the base level and at three and six months after treatment. Results: While comparing between two groups, the median FPG was high, 15.0 (13.6-18.3) vs. 14.4 (10.5-16.9), in both groups at the base level. Over the six months, FPG was gradually reduced in both groups but significantly reduced in IDeg patients (P = 0.03), although median HbA1c was higher, 9.9 (8.4-12.0), in IDeg patients than in IDet patients, 9.3 (8.1-10.4), at the base level but reduced significantly in IDeg patients, 8.4 (7.6-9.0), compared with IDet patients, 9.0 (8.1u9.7), after six months (P = 0.042). Though mild hypoglycemia was documented, there was no incidence of severe hypoglycemia in IDet or IDeg groups. Conclusion: In conclusion, in our study population, the IDeg group had more improvement in glycemic control, reducing FPG, than the IDet group. Moreover, there was more reduction of basal insulin dose in IDeg than in IDet after six months of starting the therapy.