OBJECTIVE: Initiation of continuous subcutaneous insulin therapy (CSII) requires an appropriate basal rate profile. Different approaches exist; however, there is a lack of evidence-based recommendations, especially in young children. STUDY DESIGN: In this large multicenter survey, 5941 CSII patients from the German/Austrian prospective documentation system (DPV) were analyzed. Patients were divided into four age groups: <6 yr (n = 837), 6 to <12 yr (n = 1739), 12 to <18 yr (n = 2985) and 18 to <25 yr (n = 380). Basal insulin requirement and diurnal distribution were evaluated based on the most recent documentation for each patient. RESULTS: Basal insulin requirement differed significantly between the four age groups (<6: 0.25 ± 0.12; 6 to <12: 0.33 ± 0.12; 12 to <18: 0.43 ± 0.15; 18 to <25: 0.35 ± 0.13 U/kg; p < 0.001). Circadian insulin profiles were markedly different between the younger and older age groups. In addition to age, longer diabetes duration, female gender, higher HbA1c and lower body mass index standard deviation score (BMI-SDS) were related to higher basal insulin requirement per kilogram of body weight. CONCLUSIONS: Age of the patient is the primary factor that influences both total daily requirement and circadian distribution of basal insulin in CSII. Experience from a large database may therefore facilitate the initiation of pump therapy in pediatric patients.
OBJECTIVE: Initiation of continuous subcutaneous insulin therapy (CSII) requires an appropriate basal rate profile. Different approaches exist; however, there is a lack of evidence-based recommendations, especially in young children. STUDY DESIGN: In this large multicenter survey, 5941 CSII patients from the German/Austrian prospective documentation system (DPV) were analyzed. Patients were divided into four age groups: <6 yr (n = 837), 6 to <12 yr (n = 1739), 12 to <18 yr (n = 2985) and 18 to <25 yr (n = 380). Basal insulin requirement and diurnal distribution were evaluated based on the most recent documentation for each patient. RESULTS: Basal insulin requirement differed significantly between the four age groups (<6: 0.25 ± 0.12; 6 to <12: 0.33 ± 0.12; 12 to <18: 0.43 ± 0.15; 18 to <25: 0.35 ± 0.13 U/kg; p < 0.001). Circadian insulin profiles were markedly different between the younger and older age groups. In addition to age, longer diabetes duration, female gender, higher HbA1c and lower body mass index standard deviation score (BMI-SDS) were related to higher basal insulin requirement per kilogram of body weight. CONCLUSIONS: Age of the patient is the primary factor that influences both total daily requirement and circadian distribution of basal insulin in CSII. Experience from a large database may therefore facilitate the initiation of pump therapy in pediatric patients.
Authors: Marietta Stadler; Sandra Zlamal-Fortunat; Ingrid Schütz-Fuhrmann; Birgit Rami-Merhar; Elke Fröhlich-Reiterer; Sabine Hofer; Julia Mader; Michael Resl; Alexandra Kautzky-Willer; Raimund Weitgasser; Rudolf Prager; Martin Bischof Journal: Wien Klin Wochenschr Date: 2016-04 Impact factor: 1.704
Authors: Bartlomiej Matejko; Katarzyna Cyganek; Barbara Katra; Danuta Galicka-Latala; Malgorzata Grzanka; Maciej T Malecki; Tomasz Klupa Journal: Rev Diabet Stud Date: 2011-08-10
Authors: Beate Karges; Thomas Meissner; Andrea Icks; Thomas Kapellen; Reinhard W Holl Journal: Nat Rev Endocrinol Date: 2011-11-29 Impact factor: 43.330
Authors: Ana Chico; Diana Tundidor; Lluis Jordana; Ignasi Saigi; Miguel A Maria; Rosa Corcoy; A de Leiva Journal: J Diabetes Sci Technol Date: 2014-02-05