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Published on: June 11, 2012
Insulin Usage and Practices in Children and Adolescents with Type 1 Diabetes
Ashrita Donepudi1, Harshini S Donepudi2, Mythili Ayyagari3
1Andhra Medical College, Visakhapatnam, Andhra Pradesh, India.
Insights
In India, conventional insulins and vial-syringes are common for type 1 diabetes (T1D) in children. Better glycemic control is seen with analog insulins, pen devices, and basal-bolus regimens.
Area of Science:
- Pediatric Endocrinology
- Diabetes Management
- Public Health
Background:
- Limited data exists on insulin usage and practices among children and adolescents with type 1 diabetes (T1D) in India.
- Understanding current practices is crucial for improving diabetes care in this population.
Purpose of the Study:
- To analyze insulin types and regimens used in pediatric T1D patients.
- To investigate insulin administration techniques and devices.
- To assess insulin storage and disposal methods.
Main Methods:
- An observational, cross-sectional study was conducted.
- Data was collected from 90 children and adolescents with T1D using a predesigned questionnaire.
- Informed consent and demographic history were obtained.
Main Results:
- Conventional insulins and vial-syringes were predominantly used.
- Basal-bolus (BB) regimen was employed by 49% of subjects.
- Mean HbA1c was 9.11±2.2%; analog insulin users had significantly lower HbA1c (7.6%) compared to conventional insulin users (9.3%).
- Improved glycemic control (HbA1c <8%) was associated with younger age, shorter T1D duration, pen devices, and BB regimen.
- Barriers to insulin use included fear of hypoglycemia (37%), inaccessibility (20%), and apprehension of injections (18%).
Conclusions:
- Conventional insulins and vial-syringes remain the primary insulin delivery systems in this cohort.
- Analog insulins, pen devices, and BB regimens are associated with better glycemic control in pediatric T1D.
- Addressing barriers like fear of hypoglycemia and improving access are vital for optimal diabetes management.
Context:
Data on insulin usage and practices in children and adolescents with type 1 diabetes (T1D) is sparse in India.
Aims:
To analyze the various insulin types and regimens used by children and adolescents with T1D, the techniques and the devices used for insulin administration, and the storage and disposal methods of delivery devices.
Settings And Design:
Observational cross-sectional study.
Methods And Materials:
Study subjects were children and adolescents with T1D ≥6 months and informed consent was obtained. A detailed demographic history was collected, and a predesigned, pretested questionnaire was used.
Results:
The number of subjects were 90 (M: F; 32:58), age ranging from 3 to 18 years and duration of T1D was 6 months to 16 years. Mean age was 13 ± 4.6 yrs, HbA1c was 9.11 ± 2.2% and duration was 5 years. Conventional insulins were more commonly used than analogs. Basal-bolus (BB) regimen was used in 49% of the subjects. Mean HbA1c for analogs was 7.6% and conventional was 9.3% (p = 0.001). HbA1c <8% was significantly more in those aged 3-8 yrs, mean duration ≤4.1 yrs, those using pens and BB regimen. Fifty-six percent were using own refrigerators for storage and the most common barriers for insulin usage were fear of hypoglycemia (37%), inaccessibility (20%), and apprehension of shots (18%). Site rotation patterns were followed by 84% and 94% of the subjects reported disposing syringes and sharps as general waste.
Conclusions:
Conventional insulins and vial-syringes remain the most commonly used insulin delivery systems. Glycemic control was better in younger age, lesser duration, BB regimen, analog usage, and pen devices.
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