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MEALTIME BOLUS INSULIN DOSE TIMING IN CHILDREN WITH TYPE 1 DIABETES: REAL-LIFE DATA FROM A TERTIARY CARE CENTRE IN

L Rohilla1, D Dayal1, N Gujjar1

  • 1Post Graduate Institute of Medical Education and Research - Endocrinology and Diabetes Unit, Department of Pediatrics, Chandigarh, India.

Acta Endocrinologica (Bucharest, Romania : 2005)
|June 24, 2022
PubMed

Insights

Administering insulin bolus after meals for children with type 1 diabetes (T1D) showed similar glycemic control and safety compared to premeal dosing. This real-world study suggests flexible insulin timing may be effective for young children with T1D.

Area of Science:

  • Pediatrics
  • Endocrinology
  • Metabolic Diseases

Background:

  • Type 1 diabetes (T1D) management in young children typically involves preprandial (before meal) insulin bolus administration.
  • Limited real-world data exists on postprandial (after meal) insulin bolus timing in this age group.
  • Previous controlled studies on pre- vs. postprandial insulin bolus have yielded variable results.

Observation:

  • This retrospective study analyzed data from 44 children under 7 years old with T1D.
  • Children were divided into two groups: preprandial insulin bolus (Group 1) and postprandial insulin bolus (Group 2).
  • Mean follow-up duration was two years.

Findings:

  • No significant differences were observed in mean glycosylated hemoglobin (HbA1c) levels between the preprandial and postprandial groups.
  • Hypoglycemic events and diabetic ketoacidosis (DKA) episodes were comparable in both groups.
  • Postprandial insulin bolus administration demonstrated similar long-term glycemic control and safety profiles.

Implications:

  • Flexible insulin bolus timing (during or after meals) appears safe and effective for young children with T1D.
  • These findings support considering postprandial insulin bolus as a viable option for managing T1D in this population.
  • Larger real-world studies are warranted to further investigate flexible insulin bolus strategies in pediatric T1D.
Abstract

Keywords:
Type 1 diabetesmealtime insulin bolusrapid-acting insulinsyoung children

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