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Starting subcutaneous insulin doses in a paediatric population with newly diagnosed type 1 diabetes

Lisa Lemieux1, Susan Crawford, Danièle Pacaud

  • 1Division of Endocrinology, Department of Paediatrics, University of Calgary, Calgary, Alberta.

Paediatrics & Child Health
|July 7, 2011
PubMed

Insights

Starting insulin doses for type 1 diabetes in children do not increase hypoglycemia risk. However, very young children (under six) given higher starting doses face a greater risk of low blood sugar.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Starting subcutaneous insulin doses for children newly diagnosed with type 1 diabetes exhibit significant variability, ranging from 0.2 to 0.8 units/kg/day.
  • The optimal initial insulin dosage in pediatric type 1 diabetes remains an area of clinical inquiry.

Purpose of the Study:

  • To investigate potential correlations between the initial subcutaneous insulin dose and diabetes-related outcomes in children.
  • To assess the relationship between starting insulin dose and the incidence of hypoglycemia in newly diagnosed pediatric type 1 diabetes patients.

Main Methods:

  • Retrospective chart review of children newly diagnosed with type 1 diabetes.
  • Comparison of hypoglycemia prevalence within the first 48 hours between children receiving low (≤0.5 units/kg/day) and high (>0.5 units/kg/day) starting insulin doses.

Main Results:

  • A total of 97 children were analyzed: 42 received a low starting dose and 55 received a high starting dose.
  • Mild hypoglycemia within 48 hours occurred in 36.4% of children younger than six receiving a high starting dose, compared to 16.0% (ages 6-10) and 5.3% (older than 10).

Conclusions:

  • Higher starting insulin doses were not associated with increased overall hypoglycemia risk in pediatric type 1 diabetes.
  • Children younger than six years old represent a subgroup at higher risk for hypoglycemia when initiated on higher starting insulin doses.
Abstract

Keywords:
AdolescentsChildrenInsulin therapyType 1 diabetes

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