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Multicenter Study
. 2010 May;33(5):1031-3.
doi: 10.2337/dc09-2249. Epub 2010 Feb 25.

Long-acting insulin analogs and the risk of diabetic ketoacidosis in children and adolescents with type 1 diabetes: a prospective study of 10,682 patients from 271 institutions

Beate Karges  1 , Thomas Kapellen, Andreas Neu, Sabine E Hofer, Tilman Rohrer, Joachim Rosenbauer, Johannes Wolf, Reinhard W Holl; Diabetes Prospective Documentation DPV Initiative; German Federal Ministry for Education and Research BMBF Competence Network of Diabetes Mellitus
Affiliations
Multicenter Study

Long-acting insulin analogs and the risk of diabetic ketoacidosis in children and adolescents with type 1 diabetes: a prospective study of 10,682 patients from 271 institutions

Beate Karges et al. Diabetes Care. 2010 May.

Abstract

OBJECTIVE To investigate if long-acting insulin analogs decrease the risk of diabetic ketoacidosis (DKA) in young individuals with type 1 diabetes. RESEARCH DESIGN AND METHODS Of 48,110 type 1 diabetic patients prospectively studied between 2001 and 2008, the incidence of DKA requiring hospitalization was analyzed in 10,682 individuals aged </=20 years with a diabetes duration of >/=2 years. RESULTS The overall rate of DKA was 5.1 (SE +/- 0.2)/100 patient-years. Patients using insulin glargine or detemir (n = 5,317) had a higher DKA incidence than individuals using NPH insulin (n = 5,365, 6.6 +/- 0.4 vs. 3.6 +/- 0.3, P < 0.001). The risk for DKA remained significantly different after adjustment for age at diabetes onset, diabetes duration, A1C, insulin dose, sex, and migration background (P = 0.015, odds ratio 1.357 [1.062-1.734]). CONCLUSIONS Despite their long-acting pharmacokinetics, the use of insulin glargine or detemir is not associated with a lower incidence of DKA compared with NPH insulin.

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