Abstract
To determine the impact of glargine insulin therapy with different nutritional models on key parameters of diabetes including quality of life, behavior in children and adolescents with type 1 diabetes. Age, duration of diabetes, HbA1c, anthropometric data and episodes of severe hypoglycemia were taken from patients’ charts. Diabetes quality of life scale and childhood behavior checklist questionnaires were given to each child at the start and at the end of 6 months. Mean age when starting on glargine insulin was 15.5 ± 3. 8 years. Duration of diabetes was 7.1 ± 4.3 years. About 14 of the patients chose to be in the carbohydrate counting group, whereas 24 of them continued with exchange meal plan as nutritional model. There was a reduction in HbA1c levels from 7.86 to 7.1% in the carbohydrate group and 8.8 to 8.0% in the exchange meal plan group. Total daily insulin dose did not change in both of the groups. BMI did not change in both of the groups. Diabetes-related worries decreased in carbohydrate group. No change was found in the behavior scores in both of the groups at the end of the study period. The use of glargine therapy among adolescents with type 1 diabetes was associated with improved overall glycemic control.
Similar content being viewed by others
References
DCCT: The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long term complications in IDDM. New Engl J Med 329:977–986
Heinemann L, Richter B (1993) Clinical pharmacology of human insulin. Diabetes Care 16(suppl 3):5900–5100
Home PD, Ashwell SG (2002) An overview of insulin glargine. Diabetes Metab Res Rev 18:S57–S63
Mohn A, Dunger DB, Chiarelli F (2001) The potential role of insulin anologues in the treatment of children and adolescents with type 1 diabetes mellitus. Diabetes Nutr Metab 14:349–357
Ingersoll GM, Marrero G (1991) A modified quality of life measure for youths: psychometric properties. Diabetes Educ 7:114–118
Guttman Bauman I, Flaherty BP, Strugger M, McEvoy R (1998) Diabetes Care 21:915–918
Fonagy P, Moran GS, Lindsay MKM, Kurtz AB, Brown R (1987) Psychological adjustment and diabetic control. Arch Dis Child 62:1009–1013
Swift PG (ed) (2000) ISPAD Consensus guidelines for the management of type 1 diabetes mellitus in children and adolescents. Medical forum international, Netherlands
Achenbach TM, Howell CT, Quay HC, Conners CK (1991) National survey of problems and competencies among four- to sixteen-year-olds: parents’ reports for normative and clinical samples. Monogr Soc Res Child Dev 56(3):1–131
Erol N, Arslan N, Akçakın M (1995) The adaptation and standardization of child behavior checklist among 6–18 year old Turkish children. In: Segent J (ed) Eunethydis European approaches to hyperkinetic disorders. Fotorotor Egg, Zurich, pp 109–113
Jacobson AM, de Groot M, Samson JA (1994) The evaluation of two measures of QOL in patients with Type 1 and type 2 diabetes. Diabetes Care 17:267–274
Parkerson GR, Connis RT, Broadhead WE, Patrick DL, Taylor TR, Tse JC (1993) Disease specific vs generic measurement of health related QOL in IDDM patients. Med Care 31:629–639
Graue M, Wentzel-Larsen T, Hanestad BR, Batsvik B, Sovik O (2003) Measuring self reported, health related, quality of life in adolescents with type 1 diabetes using both generic and disease specific instruments. Acta Paediatr 92(10):1190–1196
Guttman Bauman I, Flaherty BP, Strugger M, McEvoy R (1998) Metabolic control and quality of life self-assessment in adolescents with IDDM. Diabetes Care 21:6915–6918
Hoey H, Aanstoot H, Chiarelli F et al (2001) Good metabolic control is associated with better quality of life in 2101 adolescents with type 1 diabetes. Diabetes Care 24:1923–1928
Vanelli M, Chiarelli F, Chiari G, Tumini S (2003) Relationship between metabolic control and quality of life in adolescents with type 1 diabetes. Report from two Italian centers for the management of diabetes in childhood Acta Biomed Ateneo Parmense Suppl 1:13–17
McMohan SK, Airey FL, Marangou DA, McElwee KJ, Carne CL, Clarey AJ, Jones TW (2005) Insulin pump therapy in children and adolescents: improvements in key parameters of diabetes management including quality of life. Diabet Med 22(1):92–96
Castro D, Tubina-Rufi D, Moret L, Fombonne E (2000) Psychological adjustment in a French cohort type 1 diabetic children. PEDIAB Collabrative Group Diabetes Metab 1:29–34
Worrall-Davies A, Owens D, Holland P, Haigh D (2002) The effect of parental expressed emotion on glycemic control in children with Type 1 diabetes. Parental expressed emotion and glycemic control in children. J Psychosom Res 52:107–113
Diabetes Control and Complications Trial Research Group (1998) Weight gain associated with intensive therapy in the diabetes control and complications trial. Diabetes Care 11:567–573
Alemzadeh R, Berhe T, Wyatt DT (2005) Flexible insulin therapy with glargine insulin improved glycemic control and reduced severe hypoglycemia among preschool aged children with type 1 diabetes mellitus. Pediatrics 115:1320–1324
Alemzedah R, Palmo Sito P, Parton E, Totka J, Kirby M (2003) Beneficial effects of flexible insulin therapy in children and adolescents with type 1 diabetes mellitus. Acta Diabetol 40:137–142
Diabetes Control and Complications Trial Research Group (1991) Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med 90:450–454
Bott S, Bott U, Berger M, Muhlhauser I (1997) Intensified insulin therapy and the risk of severe hypoglycemia. Diabetologia 40:926–933
Pampanelli S, Fanelli C, Lalli C et al (1996) Long term intensive therapy in IDDM: effects on HbA1c, risk of severe and mild hypoglycemia, status of counter regulation and awareness of hypoglycemia. Diabetologia 39:677–686
Hathout EH, Fujishige L, Geach J, Ischandar M, Maruo S, Mave JW (2003) Effect of therapy with insulin glargine on glycemic control in toddlers, children and adolescents with diabetes. Diabetes Technol Ther 5:801–806
Witthaus E, Stewart J, Bradley C (2001) Treatment satisfaction and psychological well-being with insulin glargine compared with NPH in patients with Type 1 diabetes. Diabet Med 18(8):619–625
Chase P, Dixon B, Pearson J et al (2003) Reduced hypoglycemic episodes and improved glycemic control in children with type 1 diabetes using insulin glargine and NPH insulin. J Pediatr 143:737–740
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Goksen, D., Darcan, S., Buyukinan, M. et al. The effect of insulin glargine and nutritional model on metabolic control, quality of life and behavior in children and adolescents with type 1 diabetes mellitus. Acta Diabetol 45, 47–52 (2008). https://doi.org/10.1007/s00592-007-0019-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00592-007-0019-2