Mark D. Wheeler & Margarita Barrientos-Perez & Fu-Sung Lo & Bo Liang & Alison Lunsford & Ólöf Thórisdóttir &
Nehama Zuckerman-Levin, A 26-week, randomized trial of insulin detemir versus NPH insulin in children and adolescents with type 2 diabetes (iDEAt2). European Journal of Pediatrics (2018) 177:1497–1503.
There are limited studies evaluating the safety and efficacy of treatments in young people with type 2 diabetes (T2D). This
study compared the efficacy and safety of insulin detemir versus neutral protamine Hagedorn (NPH) insulin, both in combination with metformin and lifestyle intervention, in children and adolescents with T2D. This randomized, open-label, phase 3 trial recruited patients (n = 42) aged 10–17 years diagnosed with T2D already receiving metformin ± other oral antidiabetic drugs ± basal insulin. Patients were randomized (1:1) to receive either insulin detemir or NPH insulin, both with the maximum tolerated dose of metformin, and lifestyle intervention, over 26 weeks. Enrollment terminated prematurely after 17 months due to a very slow recruitment rate (12% of the target met). After 26 weeks, the observed mean HbA1c value had decreased by 0.61% points in the insulin detemir group vs. 0.84% points in the NPH insulin group. The rate of symptomatic blood glucose-confirmed hypoglycemic episodes was 0.4 episodes/patient-year of exposure (PYE) for insulin detemir vs. 1.1 episodes/PYE for NPH insulin.
Conclusion: No safety issues were revealed with either basal insulin. Due to the low number of patients recruited, no efficacy
conclusions could be drawn.