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lüll Institution of basal-bolus therapy at diagnosis for children with type 1 diabetes mellitus Adhikari S; Adams-Huet B; Wang YC; Marks JF; White PCPediatrics 2009[Apr]; 123 (4): e673-8OBJECTIVE: We studied whether the institution of basal-bolus therapy immediately after diagnosis improved glycemic control in the first year after diagnosis for children with newly diagnosed type 1 diabetes mellitus. METHODS: We reviewed the charts of 459 children > or =6 years of age who were diagnosed as having type 1 diabetes between July 1, 2002, and June 30, 2006 (212 treated with basal-bolus therapy and 247 treated with a more-conventional neutral protamine Hagedorn regimen). We abstracted data obtained at diagnosis and at quarterly clinic visits and compared groups by using repeated-measures, mixed-linear model analysis. We also reviewed the records of 198 children with preexisting type 1 diabetes mellitus of >1-year duration who changed from the neutral protamine Hagedorn regimen to a basal-bolus regimen during the review period. RESULTS: Glargine-treated subjects with newly diagnosed diabetes had lower hemoglobin A1c levels at 3, 6, 9, and 12 months after diagnosis than did neutral protamine Hagedorn-treated subjects (average hemoglobin A1c levels of 7.05% with glargine and 7.63% with neutral protamine Hagedorn, estimated across months 3, 6, 9, and 12, according to repeated-measures models adjusted for age at diagnosis and baseline hemoglobin A1c levels; treatment difference: 0.58%). Children with long-standing diabetes had no clinically important changes in their hemoglobin A1c levels in the first year after changing regimens. CONCLUSION: The institution of basal-bolus therapy with insulin glargine at the time of diagnosis of type 1 diabetes was associated with improved glycemic control, in comparison with more-conventional neutral protamine Hagedorn regimens, during the first year after diagnosis.|Blood Glucose/analysis[MESH]|Child[MESH]|Diabetes Mellitus, Type 1/*drug therapy/physiopathology[MESH]|Glycated Hemoglobin[MESH]|Humans[MESH]|Hypoglycemic Agents/*administration & dosage[MESH]|Insulin Glargine[MESH]|Insulin, Isophane/*administration & dosage[MESH]|Insulin, Long-Acting[MESH]|Insulin/administration & dosage/*analogs & derivatives[MESH]|Patient Compliance[MESH]|Retrospective Studies[MESH]|Treatment Outcome[MESH] |