Search

Background: Adolescence is a transitional phase characterized by multiple physiological and psychosocial factors that make glycemic control more difficult, and often results in hyperglycemia and/or hypoglycemia-related emergencies, and increases the risk of chronic complications. Insulin analogs were introduced with the aim of overcoming such difficulties. Objective: To study the role of long acting insulin analog (insulin glargine) in glycemic control of adolescents with poorly controlled type 1 diabetes who suffer from frequent hypoglycemic attacks and marked glucose variability, and to compare its effectiveness and cost versus intermediate acting insulin (NPH) in a country with limited resources like Egypt. Subject and method: A non-randomized open label treat to target trial that included twenty-nine adolescents (10–18 years), with T1DM. They were on MDI regimen. All had unsatisfactory glycemic control with frequent hypoglycemia and/or recurrent glucose excursions. All were shifted from twice daily NPH to single bedtime injection of insulin glargine (Lantus), and followed up for a minimum period of 6 months. Results: Switching to insulin glargine was associated with a statistically significant reduction in attacks of hypoglycemia and DKA (p