Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes

OBJECTIVE To compare the glucose variability associated with insulin glargine and NPH/Lente insulin used as the basal insulin component of a multiple daily injection (MDI) regimen in pediatric patients with type 1 diabetes. RESEARCH DESIGN AND METHODS Continuous glucose monitoring data were collected from a subset of patients (n = 90) who agreed to use a continuous glucose monitoring system during an active-controlled, randomized, open-label study evaluating the safety and efficacy of insulin glargine and NPH/Lente insulin used with insulin lispro as part of an MDI regimen. RESULTS Treatment with insulin glargine resulted in significant reductions in glucose variability as measured by the SD of glucose values (adjusted mean change from baseline to week 24: -13.4 mg/dl [-0.74 mmol/l]; P <or= 0.05), mean amplitude of glycemic excursion (-34.4 mg/dl [-1.91 mmol/l]; P <or= 0.0001), and M value (-9.6 mg/dl [-0.53 mmol/l]; P <or= 0.03). The corresponding reductions in glucose variability for NPH/Lente were not significant. CONCLUSIONS Insulin glargine is associated with greater reductions in glucose variability than NPH/Lente insulin in pediatric patients with type 1 diabetes.