![conference banner](/images/conference-banner.jpeg)
Abstract
Background: Diabetes control without developing hypoglycemia is challenging in Type 1 diabetes (T1D) management, with few studies evaluating the effect of insulin glargine timing on glucoregulation.
Objectives: The aim is to compare glycemic control using continuous glucose monitoring (CGM) in children with T1D receiving bedtime versus morning glargine and to assess CGM effect on glycemia.
Methods: This cross-sectional observational study was conducted on 30 pediatric patients with T1D receiving glargine (19 at bedtime and 11 in the morning). CGM sensor was applied for 3-5 days using the I-Pro2 blood glucose sensor.
Results: Total daily dose of glargine showed a significant correlation with HbA1C (p=0.006) and percentage of glucose readings within average (p=0.039). HbA1C correlated significantly with time in range (TIR) (p=0.049). Nocturnal hypoglycemia was significantly higher in the bedtime glargine group than in the morning one (p=0.016). The morning glargine group showed better control in terms of lower HbA1C and higher TIR, but these did not reach statistical significance. Follow- up after 3 months revealed significant improvement in the percentage of hyperglycemia, BG readings within average, as well as HbA1c (p:0.001).
Conclusions: Bedtime glargine administration was associated with a higher frequency of occurrence of nocturnal hypoglycemia. No statistically significant difference in glycemic control between both groups was found. CGM use improved glycemic control.
Keywords: Continuous glucose monitoring, glycemic control, insulin glargine, nocturnal hypoglycemia, type 1 diabetes, timing of administration.
[http://dx.doi.org/10.1111/pedi.12742] [PMID: 30079595]
[http://dx.doi.org/10.2337/dc11-1723] [PMID: 22025785]
[http://dx.doi.org/10.2337/dc14-0649] [PMID: 25524950]
[http://dx.doi.org/10.2337/dc17-S009] [PMID: 27979893]
[http://dx.doi.org/10.1007/s13300-015-0130-2] [PMID: 26369657]
[http://dx.doi.org/10.1111/pedi.12731] [PMID: 30039513]
[http://dx.doi.org/10.17925/USE.2012.08.01.27] [PMID: 24312136]
[http://dx.doi.org/10.2337/dc17-1600] [PMID: 29162583]
[http://dx.doi.org/10.2337/dci18-0040] [PMID: 30787056]
[http://dx.doi.org/10.2337/dc18-1444] [PMID: 30352896]
[http://dx.doi.org/10.2337/dc18-1581] [PMID: 30224348]
[http://dx.doi.org/10.2337/diacare.26.6.1738] [PMID: 12766103]
[http://dx.doi.org/10.2174/1573399817666210303095633] [PMID: 33655870]
[http://dx.doi.org/10.1097/MED.0000000000000599] [PMID: 33315628]
[http://dx.doi.org/10.4008/jcrpe.v1i1.10] [PMID: 21318060]
[http://dx.doi.org/10.2337/diacare.28.6.1282] [PMID: 15920040]
[http://dx.doi.org/10.1089/dia.2018.0310] [PMID: 30575414]
[http://dx.doi.org/10.1111/dme.14065] [PMID: 31267573]
[http://dx.doi.org/10.1089/dia.2017.0035] [PMID: 28585879]
[http://dx.doi.org/10.1002/14651858.CD008101.pub2]
[http://dx.doi.org/10.4103/2230-8210.131130] [PMID: 24944918]
![Wayfinder Image](/images/wayfinder.jpg)