Long-acting Insulin Analogs Effect on gh/igf Axis of Children with Type 1 Diabetes: A Randomized, Open-label, Two-period, Cross-over Trial. Cherubini V., Pintaudi B., Iannilli A., Pambianchi M., Ferrito L., & Nicolucci A. 2016.
Long-acting Insulin Analogs Effect on gh/igf Axis of Children with Type 1 Diabetes: A Randomized, Open-label, Two-period, Cross-over Trial [link]Paper  abstract   bibtex   
Background: Growth hormone (GH) secretion is increased in pre-pubertal children with type 1 diabetes and GH excess produces insulin resistance. Early-morning insulinopenia contributes to lower insulin-like growth factor (IGF-I) levels and to GH hypersecretion. Objective: To evaluate differences in GH/IGF-I axis of pre-pubertal children with type 1 diabetes treated with glargine or detemir as long-acting insulin analogues, which was the main outcome measure, and to compare insulin effects in obtaining good metabolic control. Subjects: Children with type 1 diabetes. Methods: This was a 32-week, randomized, open-label, two-period, cross-over comparison between bedtime glargine and twice-daily detemir insulin, involving pre-pubertal children in care at a diabetes pediatric centre. After a 8-week-run-in period subjects were randomized to bedtime glargine or twice-daily detemir insulin administration. After a 12-week period treatments were inverted and continued for additional 12 weeks. Results: Overall, 15 pre-pubertal children (53.3% males, mean age 8.6+/-1.5 years, duration of diabetes 4.2+/-1.5 years) completed the study. Groups did not differ for GH/IGF axis and HbA1c levels. Treatment with glargine was associated with lower fasting glucose values than treatment with detemir (8.1+/-1.5 vs. 8.2+/-1.7 mmol/L, p=0.01). Incidence rate of hypoglycemia was not different between insulin treatments (IRR=1.18, 95%CI 1.00-1.38; p=0.07). Detemir treatment was associated with a higher increase in body weight (p=0.008) and height (p=0.02) when compared with glargine. Conclusion: Detemir and glargine not show significant differential effects on the GH/IGFI axis. The greater weight gain and height associated with detemir treatment, apparently not related to the level of pubertal growth, deserve further investigation. Copyright © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart New York.
@misc{cherubini_v._long-acting_2016,
	title = {Long-acting {Insulin} {Analogs} {Effect} on gh/igf {Axis} of {Children} with {Type} 1 {Diabetes}: {A} {Randomized}, {Open}-label, {Two}-period, {Cross}-over {Trial}},
	url = {http://www.thieme-connect.com/ejournals/toc/eced},
	abstract = {Background: Growth hormone (GH) secretion is increased in pre-pubertal children with type 1 diabetes and GH excess produces insulin resistance. Early-morning insulinopenia contributes to lower insulin-like growth factor (IGF-I) levels and to GH hypersecretion. Objective: To evaluate differences in GH/IGF-I axis of pre-pubertal children with type 1 diabetes treated with glargine or detemir as long-acting insulin analogues, which was the main outcome measure, and to compare insulin effects in obtaining good metabolic control. Subjects: Children with type 1 diabetes. Methods: This was a 32-week, randomized, open-label, two-period, cross-over comparison between bedtime glargine and twice-daily detemir insulin, involving pre-pubertal children in care at a diabetes pediatric centre. After a 8-week-run-in period subjects were randomized to bedtime glargine or twice-daily detemir insulin administration. After a 12-week period treatments were inverted and continued for additional 12 weeks. Results: Overall, 15 pre-pubertal children (53.3\% males, mean age 8.6+/-1.5 years, duration of diabetes 4.2+/-1.5 years) completed the study. Groups did not differ for GH/IGF axis and HbA1c levels. Treatment with glargine was associated with lower fasting glucose values than treatment with detemir (8.1+/-1.5 vs. 8.2+/-1.7 mmol/L, p=0.01). Incidence rate of hypoglycemia was not different between insulin treatments (IRR=1.18, 95\%CI 1.00-1.38; p=0.07). Detemir treatment was associated with a higher increase in body weight (p=0.008) and height (p=0.02) when compared with glargine. Conclusion: Detemir and glargine not show significant differential effects on the GH/IGFI axis. The greater weight gain and height associated with detemir treatment, apparently not related to the level of pubertal growth, deserve further investigation. Copyright © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart New York.},
	journal = {Experimental and Clinical Endocrinology and Diabetes},
	author = {{Cherubini V.} and {Pintaudi B.} and {Iannilli A.} and {Pambianchi M.} and {Ferrito L.} and {Nicolucci A.}},
	year = {2016},
	keywords = {*growth hormone blood level, *growth hormone/ec [Endogenous Compound], *insulin dependent diabetes mellitus, *insulin dependent diabetes mellitus/dt [Drug Therapy], *insulin detemir/cm [Drug Comparison], *insulin detemir/ct [Clinical Trial], *insulin detemir/dt [Drug Therapy], *insulin glargine/cm [Drug Comparison], *insulin glargine/ct [Clinical Trial], *insulin glargine/dt [Drug Therapy], *long acting insulin, *protein blood level, *somatomedin/ec [Endogenous Compound], Child, article, bedtime dosage, blood glucose monitoring, body height, body weight, clinical article, clinical trial, comparative effectiveness, controlled clinical trial, controlled study, crossover procedure, diabetic patient, female, glucose blood level, glucose/ec [Endogenous Compound], growth hormone, height, hemoglobin A1c, hemoglobin A1c/ec [Endogenous Compound], hemoglobin blood level, human, hypoglycemia, incidence, insulin dependent diabetes mellitus/dt [Drug Therapy], insulin detemir, insulin glargine, insulin treatment, male, open study, pediatric hospital, prepuberty, priority journal, randomized controlled trial, somatomedin C, weight gain}
}

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