| Objective: To compare the efficiency and safety of insulin aspart preprandially plus the basal insulin glargine and Novolin 30R on beta-cell function and glycemic control in children with newly diagnosed type 1 diabetes mellitus(T1DM). Methods:1. In a prospective study, 16 cases with acute T1DM aged 7.64 ± 3.61 years received insulin aspart preprandially plus the basal insulin glargine once daily. 20 age and sex matched children with acute T1DM as control group received Novolin 30R twice daily. In 3-month treatment,the data of glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), C peptide, insulin(INS), total daily insulin dosage and frequency of hypoglycemia were compared.2. Linear correlation analysis was made between total daily insulin dosage and serum C peptide, between C peptide and FBG, HbA1c respectively.Results:1. After 3 months, the average HbA1c level of the observed group and the control group dropped from [(13. 71 ±2. 12)% vs. (12. 97 ± 2. 32)%] to [(6. 59 ± 0. 36)% vs. (7. 63 ±0. 92)%] respectively, the average HbA1c level of the observed group were significantly lower at 3 months than control group (p=0. 000). The average HbA1c change within 3 months also significantly bigger in observed group than control group[ ( 7. 12±1.99)% vs. (5. 34 ±2. 48)% p=0. 026)], and after 3 months all of the observed group achieved HbA1c values < 8%, the rate of achieving HbA1c target obviously higher than control group. The FBG were significantly lower at 1 months and 3 months than control group [(5.49 ± 1. 27)mmol/L vs. (7. 22 ± 1. 46) mmol/L and (5. 37 + 0. 95) mmol/L vs (7. 20 ± 1. 89) mmol/L, p=0. 01,p=0.001 respectively].2. Compared with the control group, the C peptide level of the observed group at the end of 3 months significantly higher[(l. 29 ± 0. 49) ng/ml vs. (0.76 ± 0.42) ng/ml (p=0. 001)]. The serum insulin values in 1 months were significantly higher in the observed group (13. 27±3. 95 uU/ml) than the control group(9. 11 ± 4. 87 uU/ml)(p=0. 044). The total daily insulin dosage at the end of 3 months was lower in observed group than control group[(0. 32 ± 0. 15) u/kg·d vs. (0. 51 ± 0. 22) u/kg·d (p=0. 036)]. The hypoglycemic episodes were lower in observed group than in control group (1 events vs. 6 events p>0. 05).3. At the end of 3 months after therapy, there was a significantly negative linear correlation between the total daily insulin dosage and C peptide(r =-0. 762, p=0. 000). And there was a significantly negative linear correlation between C peptide and FBG(r=-0. 490, p<0. 01),HbA1c(r =-0. 381, p<0. 01) respectively.Conclusions:1. Intensive therapy with insulin aspart preprandially plus the basal insulin glargine in children with type 1 diabetes mellitus is superior to Novolin 30R by better glycemic control and less hypoglycemic episodes, which also reduced the total daily insulin dosage.2. The insulin level are reliable evidence of the total daily insulin dosage . And The serum C peptide and insulin level are both reliable evidence of beta-cell function and help to adjust insulin.3. The good glycemic control by FBG and HbA1c help to recover the pancreatic beta-cell function, which is important to newly diagnosed T1DM children.
|
PDF Full Text Request