Document Detail

Difference in insulin usage patterns with pubertal development in children with type 1 diabetes during transition from multiple daily injections to continuous subcutaneous insulin infusion (CSII) and through the CSII treatment.
MedLine Citation:
PMID:  20001677     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study analyzed the changes in insulin requirement in the transition from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII) and the differences through the CSII treatment in pediatric patients in different pubertal developmental stages. METHODS: We analyzed, through a longitudinal retrospective study, the insulin usage patterns and glycemic control of 40 patients with type 1 diabetes on CSII treatment for 12 months. The patients were subdivided in three groups: group A, 13 prepubertal subjects (Tanner stage I); group B, 15 pubertal subjects (Tanner stage II-IV); and group C, 12 postpubertal subjects (Tanner stage V). RESULTS: During the transition from MDI to CSII, the insulin requirements decreased significantly by 21 +/- 5% (0.89 +/- 0.26 U/kg/day vs. 0.70 +/- 0.11 U/kg/day). Through the CSII treatment the percentage of total daily insulin delivered as the basal rate in groups A, B, and C was 54-60%, 52-54%, and 52-54%, respectively. The number of basal rates per day was significantly higher in groups A and B. The overall profile of basal rate differed among the groups. During the night, prepubertal patients required more insulin from 12 p.m. to 2 a.m., whereas pubertal and postpubertal patients required more insulin between 2-3 a.m. to 7 a.m. Prepubertal patients had a maximum basal rate between 9 a.m. to 12 a.m. and 2 p.m. to 4 p.m., in contrast to pubertal and postpubertal patients between 2 p.m. to 3 p.m. and 5 p.m. to 6 p.m. The number of "extra" boluses per day was significantly higher in groups B and C compared to group A. CONCLUSIONS: Age-related differences exist in insulin usage patterns of pediatric patients on pump treatment. A greater knowledge of these variations may help to obtain optimum conditions in the CSII treatment in pediatric patients.
B Shashaj; N Sulli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  11     ISSN:  1557-8593     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-03-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  767-74     Citation Subset:  IM    
Department of Pediatrics, Diabetes Center, University of Rome La Sapienza, Rome, Italy.
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MeSH Terms
Age Factors
Blood Glucose
Body Mass Index
Child, Preschool
Diabetes Mellitus, Type 1 / blood,  drug therapy*
Drug Administration Schedule
Hemoglobin A, Glycosylated / metabolism
Hypoglycemic Agents* / administration & dosage,  metabolism
Infusions, Subcutaneous
Injections, Subcutaneous*
Insulin* / administration & dosage,  metabolism
Insulin Infusion Systems*
Longitudinal Studies
Puberty / metabolism*
Retrospective Studies
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 11061-68-0/Insulin

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