Preliminary Data of Insulin Glargine Use among Thai Adolescents and Young Adults with Type 1 Diabetes Mellitus Treated at Siriraj Hospital
Pairunyar Sawathiparnich MD*, Pornpimol Kiattisakthavee RN*, Jeerunda Santiprabhob MD*, Supawadee Likitmaskul MD*
Affiliation : *Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Insulin glargine is a new long-acting insulin analog with a duration of action of 24 hours and can be
given once a day as the only basal insulin combined with short or rapid-acting insulin as bolus insulin for
each meal.
The goals of this study were to evaluate short term result of treatment with insulin glargine compared
to NPH and to determine the initial dosage of insulin glargine in Thai adolescents with type 1 diabetes.
We reviewed charts of 10 adolescents (median age 20.8 years, range 12.3-22.7 years) with type 1
diabetes who had received insulin glargine for > 4 months (median 16.5 months, range 4-25 months). Before
switching to insulin glargine, all patients received NPH. Seventy percent of subjects had improvement of
HbA1c from 10.4% (range 8.2-12.6) to 8% (range 6.7-10.6). The total amount of insulin dosage was signifi-
cantly decreased from 1.2 (range 0.9-2.4) to 0.9 (range 0.4-1.5) units/kg/day as well as the percentage of
basal insulin which was decreased from 70% (range 67-81) to 47% (range 38-56) of the total daily insulin.
Insulin glargine did not cause severe hypoglycemia in this study.
Conclusion : Insulin glargine is another promising therapy for adolescents with type 1 diabetes. We recommend
the starting total daily insulin dosage to be decreased to 70-80% of previous dosage. Insulin glargine should be
started at 50 % of the new total daily insulin dosage.
Keywords : Insulin glargine, NPH, Type 1 diabetes mellitus, HbA1c
