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Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on

Ron J Schulten1, Jessica Piet1, Patricia Cjl Bruijning2

  • 1Department of Pediatrics, Diakonessenhuis Utrecht, Utrecht, The Netherlands.

Pediatric Diabetes
|February 17, 2016
PubMed

Insights

Lowering the percentage of basal insulin dose in children with type 1 diabetes on insulin pump therapy improves glycemic control. A 10% change in basal insulin percentage impacts HbA1c levels by 0.22%.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Type 1 diabetes (T1D) management in children requires optimized insulin therapy.
  • Continuous subcutaneous insulin infusion (CSII) is a common treatment modality for T1D.
  • Understanding the impact of insulin dosing strategies on glycemic control is crucial for pediatric diabetes care.

Purpose of the Study:

  • To investigate the relationship between the proportion of basal insulin dose (%BD/T) and glycemic control (HbA1c) in children with T1D on CSII.
  • To determine if %BD/T is a significant predictor of metabolic outcomes in this population.

Main Methods:

  • Retrospective analysis of outpatient visit data from 78 children with T1D on CSII therapy between 2000-2011.
  • Data included HbA1c levels, basal insulin percentage, BMI SDS, sex, and diabetes duration.
  • Multivariate analysis was employed to assess the impact of %BD/T on HbA1c.

Main Results:

  • Analysis included 847 outpatient visits.
  • A 10% increase in %BD/T was associated with a 0.22% decrease in HbA1c (95% CI: 0.15-0.29).
  • No significant effect on HbA1c was observed from BMI SDS, sex, or diabetes duration.

Conclusions:

  • A lower proportion of basal insulin dose is associated with better glycemic control (lower HbA1c) in children with T1D on CSII.
  • This finding supports strategies that aim to minimize basal insulin requirements in CSII therapy for pediatric patients.
  • Optimizing basal insulin delivery is a key component in improving metabolic outcomes for children with type 1 diabetes.
Abstract

Keywords:
basal insulin ratecontinuous subcutaneous insulin infusionmetabolic controlpediatricstype 1 diabetes mellitus

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