Comparative Effectiveness of Switching From First‐Generation Basal Insulins to Either Glargine 300 U/mL or Degludec 100 U/mL in Children and Adolescents With Type 1 Diabetes: Results From the ISPED CARD Clinical Registry
Authors' conclusion
Switching from 1BI to either Gla-300 or Deg-100 significantly improves glycemic control in pediatric T1D patients without weight gain. Although both insulins showed comparable effectiveness, differences in titration patterns highlight the need for individualized treatment strategies and improved clinician education in insulin optimization. Safety outcomes, particularly hypoglycemia, could not be assessed.
Study context
- Population
- Children and adolescents with T1D who switched from first-generation basal insulins between 2021 and 2023, 22 diabetes centers in Italy (ISPED CARD registry)353 per group after propensity score matching (PSM)
- Participants
- 1,063 children
- Exposure
- Switch from 1BI to Gla-300 vs Deg-100
- Gla-300n = 353
- Deg-100n = 353
- Outcome
- Change in HbA1c
- Follow-up
- 6 months
Methodological detailsmulticenter, registry-based, propensity score matched
- Multicenter
- Registry-based
- Propensity score matched
Main finding
As reported in the abstract
Both groups: HbA1c reduced from ≈8.7% to ≈7.4%
−1.3 percentage points
Observational data: associations, not effects.
Secondary outcomes
HbA1c · 12 months
- HbA1c reduction maintained at 12 months, no significant differences between groups
Fasting blood glucose (FBG)
- FBG decreased significantly in both groups, slightly favoring Deg-100, without significant difference between groups
BMI/SDS
- BMI/SDS remained stable
Basal insulin dose
- Gla-300: slight increase over 12 months; Deg-100: temporary reduction at 6 months
Short-acting insulin dose
- Significant reduction in both groups
- −0.03 U/kg
Original publication
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