Basal Analog Study - Comparison of Lantus or Levemir With NPH Insulin From T1DM Diagnosis

Effects of New Longacting Insulin Analogs on Metabolic Control, Endogenous Insulin Production, GH/IGF-I Axis and Quality of Life - Comparison of NPH, Glargine Och Detemir Insulin From the Debut of Type 1 Diabetes Mellitus in Adolescents

Hypothesis: Basal insulin analogs with continuous 24-hour delivery of insulin improve glycemic control during the first year of treatment of children/adolescents with type 1 diabetes mellitus (T1DM)by preserving endogenous insulin production and a close to normal balance of the GH-IGF-axis.

This a randomized, open-label, parallel-group trial of 120 children, 7 - 17 years of age, newly diagnosed with T1DM. The investigators will investigate whether the use of long-acting basal insulin analogs Lantus (Glargine) or Levemir (Detemir) during the first year of treatment results in improved glycemic control (HbA1c) compared with Insulatard (NPH insulin) when given in a meal insulin therapy regimen with rapid acting Novorapid (insulin aspart). The investigators will explore possible mechanisms of action by determining remaining endogenous insulin production and changes in the GH-IGF-axis. The investigators will also assess changes in body composition and evaluate quality of life in each treatment arm.

Inclusion Criteria:

• Diagnosis of diabetes and novel to insulin therapy
• Age 7 - 17 years
• Informed consent

Exclusion Criteria:

• Moderate to severe ketoacidosis (pH<7.2 and/or standard bicarbonate <10 mmol/l)
• Suspected non-type 1
• IA2 and GAD65: all-antibody negative
• Celiac disease or other chronic disease
• Hypothyroidism, if not well controlled
• Syndromes
• Previous anorexia nervosa
• Neuro-psychiatric disease
• Malignancy