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Development of optimal kids insulin dosing system formulas for young children with type 1 diabetes mellitus

Ramin Alemzadeh1, Raymond G Hoffmann, Mahua Dasgupta

  • 1Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. ralemzad@uic.edu

Diabetes Technology & Therapeutics
|January 14, 2012
PubMed

Insights

New Kids Insulin Dosing System (KIDS) formulas provide precise insulin dosing for young children with type 1 diabetes (T1DM). These formulas simplify insulin adjustments for continuous subcutaneous insulin infusion (CSII) therapy.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Diseases

Background:

  • Type 1 diabetes (T1DM) management in young children requires precise insulin dosing.
  • Transitioning from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) necessitates updated dosing strategies.
  • Accurate insulin delivery is crucial for optimizing glycemic control and minimizing complications.

Purpose of the Study:

  • To develop predictive formulas for accurate insulin dosing in very young children with T1DM.
  • To identify key parameters influencing optimal insulin dosage adjustments during CSII therapy.
  • To establish the Kids Insulin Dosing System (KIDS) formulas for practical clinical application.

Main Methods:

  • Analysis of 1-year data from 14 young T1DM patients (3.9 ± 0.8 years old) transitioning from MDI to CSII.
  • Evaluation of Body Mass Index (BMI), Total Daily Dose (TDD), insulin-to-carbohydrate ratio (ICR), correction factor (CF), and glycemic excursion (MAGE).
  • Determination of slope constants for relationships between dosing parameters (CF, ICR, TDD) during MDI and CSII phases.

Main Results:

  • The KIDS formulas were established as: TDD = 0.74 × body weight, total basal dose = 0.28 × TDD, CF = 2,800/TDD, and ICR = 13.5 × body weight/TDD.
  • Significant changes in the CF-TDD relationship were observed during CSII compared to MDI (P<0.0001).
  • The ICR-TDD relationship remained relatively stable, and improved glycemic control (decreased MAGE) was noted without significant changes in BMI or HbA1c.

Conclusions:

  • The interrelationships among ICR, CF, and TDD remained stable during CSII, correlating with reduced glycemic excursions.
  • The KIDS formulas offer consistent and straightforward estimation of insulin dosing factors for young T1DM patients.
  • These predictive formulas can aid clinicians in optimizing insulin therapy for pediatric T1DM management on CSII.
Abstract

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