Insulin therapy regimens in paediatric age

Area of Science:

• Pediatric Endocrinology
• Metabolic Disorders
• Pharmacology

Background:

• Children with diabetes often have complete c-peptide negativity, necessitating comprehensive insulin replacement.
• Traditional insulin preparations include regular, NPH, Lente zinc, and Ultralente zinc insulins.
• Recent advancements include short-acting insulin analogues (Lispro, Aspart) and long-acting analogues (Glargine, Detemir).

Purpose of the Study:

• To explore the personalization of insulin therapy in pediatric diabetes management.
• To highlight the role of insulin analogues in achieving good metabolic control and quality of life.
• To discuss factors influencing insulin regimen adaptation in children.

Main Methods:

• Review of current insulin therapy devices (syringes, pens, injectors).
• Analysis of traditional and analogue insulin preparations with varying pharmacokinetics.
• Consideration of patient lifestyle, age, school, and cultural factors in treatment decisions.

Main Results:

• Successful use of short-acting insulin analogues requires optimal basal insulin support.
• Insulin regimens are adapted to individual lifestyles, including meal timing and school needs.
• Effective management involves glycaemic profiles, HbA1c, metabolic control, and patient/family compliance.

Conclusions:

• Insulin regimens must be tailored to the individual lifestyle of pediatric patients undergoing intensive insulin therapy.
• Personalization of insulin therapy is a recent achievement, facilitated by both new and established insulin preparations.
• Regional lifestyle variations in Italy influence the approach to pediatric diabetes management.