The Eff ect of Insulin Detemir on the Metabolic Control in Children and Adolescents with Type 1 Diabetes Mellitus

Year 2008, Volume: 61 Issue: 4, 202 - 206, 01.04.2008

Tolga Ünüvar Ayhan Abacı Ali Ataş Ece Böber Atilla Büyükgebiz

https://doi.org/10.1501/Tipfak_0000000684

Abstract

Keywords

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Tip 1 Diyabetes Mellituslu Çocuk ve Adolesanlarda İnsülin Detemirin Metabolik Kontrol Üzerine Etkisi

Abstract

Amaç: Literatürde çocuk ve adolesan yaş grubunda insülin detemirin etkinliği, gece hipoglisemi sıklığındaki azalma ve kilo değişiklikleri hakkında sınırlı sayıda çalışma olması nedeniyle bu prospektif çalışmayı planladık. Materyal Metod: Kötü metabolik kontrollü ve/veya sabah hiperglisemileri olan 15 diyabetik hasta (10 erkek) çalışmaya dahil edildi. Hastaların ortalama yaşı 13.41±3.68 yıl ve ortalama diyabet süresi 5.03±1.74 yıldı. Hemoglobin A1c ve lipid düzeyleri, kan şekeri profilleri ve vücut kitle indeksleri başlangıçta ve detemir kulanımından 32±2.32 ay sonra değerlendirildi. Bulgular: Bazal insülin olarak insülin detemir uygulanmasından sonra ortalama HbA1c değerleri %9.08’den %8.31’e geriledi. Total ve LDL kolesterol düzeylerinde detemir sonrası istatiksel olarak anlamlı azalma görüldü. Detemire geçildikten sonra ortalama günlük kan şekeri profillerinde anlamlı azalma saptandı. Gece hipoglisemi sıklıklarında detemire geçiş sonrası anlamlı azalma saptandı. Hastaların günlük insülin dozları, bolus/bazal oranları ve BMI SDS değerlerinde anlamlı bir değişiklik olmadı. Sonuç: Bu çalışma, bazal - bolus rejimde günde tek doz detemir tedavisinin NPH ile karşılaştırıldığında özellikle dislipidemi riskinin azaltılmasında ve daha iyi metabolik kontrol sağlanmasında gece hipoglisemi riskini arttırmaksızın, etkin ve iyi tolere edilebilir olduğunu desteklemektedir.

Keywords

Detemir, NPH, Tip 1 Diyabetes Mellitus

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