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Basal insulin and total daily insulin dose in children with type 1 diabetes using insulin pumps
Author(s) -
Pańkowska Ewa,
Szypowska Agnieszka,
Lipka Maria
Publication year - 2008
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2008.00375.x
Subject(s) - medicine , insulin , diabetes mellitus , basal (medicine) , endocrinology , ketoacidosis , diabetic ketoacidosis , type 1 diabetes , c peptide , body mass index
Objective: To assess the contribution of basal insulin to the total daily dose (CBITDD) and to identify the determinant factors in children with type 1 diabetes mellitus. Study design: Cross‐sectional study in which the basal insulin requirement was established based on a memory read‐out of insulin delivery from pumps. Factors such as glycated haemoglobin A1c (HbA1c), fasting C‐peptide, standard deviation score of body mass index (sdsBMI) and demographic data were determined during routine hospital visits. Study group included a total of 90 well‐controlled diabetic children with the mean HbA1c 6.6 ± 0.7 (5.2–7.9), age 10.4 ± 4.4 yr (1.1–17.9 yr), diabetes duration 3.0 ± 2.6 yr (0.3–10.9 yr) and sdsBMI 0.08 (−2.27 to 1.79), excluding patients with ketoacidosis or infectious diseases. Results: Correlations between CBITDD and age (r = 0.39 and p < 0.005) and diabetes duration (r = 0.61 and p < 0.0001) and an inverse correlation with C‐peptide (r = −0.41 and p = 0.0001) were found. C‐peptide‐positive patients had a significantly lower percentage of basal insulin compared with C‐peptide‐negative patients (20.6 ± 11 vs. 31.6 ± 11.0%, respectively; p = 0.0004); yet, no significant difference in total insulin daily dose (0.65 ± 0.3 vs. 0.78 ± 0.2 U/kg/d, respectively) was observed. Conclusions: The percentage of basal insulin in diabetic children is below 50% and in well‐controlled diabetic children is related to the fasting C‐peptide level, age of patient and diabetes duration but not to HbA1c and sdsBMI.