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Polymorphic basal rates of continuous subcutaneous insulin infusion among Taiwanese children with type 1 diabetes

Chia-Hung Lin1, Feng-Ju Hsieh2, Yang-Hau Van2

  • 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan 333, Taiwan.

Biomed Research International
|March 25, 2015
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) in children with type 1 diabetes mellitus (T1D) requires a lower basal insulin proportion and shows varied daily insulin needs based on developmental stage. This improves glycemic control.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Basal insulin dose, total daily insulin proportion, and circadian variation in continuous subcutaneous insulin infusion (CSII) therapy for children with type 1 diabetes mellitus (T1D) remain incompletely understood.
  • Understanding these parameters is crucial for optimizing CSII therapy in pediatric T1D patients.

Purpose of the Study:

  • To elucidate the basal insulin dose, its proportion to total daily insulin, and the circadian patterns of insulin use in children with T1D undergoing CSII therapy.
  • To analyze how these parameters vary across different pubertal stages (Tanner stages).

Main Methods:

  • A retrospective analysis of 45 pediatric patients with T1D receiving CSII therapy between 2004 and 2012.
  • Patients were categorized based on Tanner stage to assess developmental differences.

Main Results:

  • CSII therapy significantly reduced HbA1c levels in all Tanner groups within three months (from 8.3% to 7.1%, P < 0.05).
  • The basal insulin proportion of total daily insulin use ranged from 34-40%.
  • Distinct circadian basal insulin patterns were observed across Tanner stages, with variations in nocturnal and daytime requirements, particularly noted in pre-pubertal, pubertal, and adolescent groups.

Conclusions:

  • Children with T1D on CSII therapy utilize a smaller proportion of basal insulin relative to their total daily insulin needs.
  • Significant variations in the circadian distribution of basal insulin requirements exist among children with T1D, correlating with pubertal development (Tanner stage).
Abstract

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