AI Summary & Key Takeaways
AI InsightCircadian distribution of BI differed markedly amongthe five age groups.Conclusion: At the initiation of insulin pump therapy, circadian profiles by age group should be taken into account in pediatric patientsto optimize basal rate faster and more easily.
📌 3 Key Takeaways
Özet
Objective: Pump-treated children with type 1 diabetes (T1DM) have widely differing basal insulin (BI) infusion profiles for specificperiods of the day. The pattern of BI requirements depends on the timing and magnitude of cortisol and growth hormone secretionwithin each age group. In adolescents and young adults, a decreased insulin sensitivity is seen, particularly in the early morning (dawnphenomenon) and to a lesser extent, in the late afternoon (dusk phenomenon). Different approaches exist for the inititation of basalrates. However, there is a lack of evidence-based recommendation, especially in young children. Usually the basal rates are set equallythroughout day and night or the day is divided into tertiles. The aim of this study was to analyze the change of the initial, equallydistributed, BI rates over the first year of standard insulin pump therapy.Methods: A total of 154 patients with T1DM, aged between 0 and 18 years, (n=5). Distribution of hourly basal rates at theinitiation of the pump and at the end of first year were evaluated.Results: Median (range) age and diabetes duration was 14.46 (1.91-26.15) and 7.89 (1.16-17.15) years, respectively. Forty-four percentwere male, 56% were female. Mean total insulin dose/kg in the whole cohort at the initiation and after one year of pump therapy was0.86±0.23 U/kg and 0.78±0.19 U/kg, respectively and differed significantly between each age group (p<0.001; p<0.001). Mean dailybasal rate/kg showed significant differences between the five groups (p<0.001). Circadian distribution of BI differed markedly amongthe five age groups.Conclusion: At the initiation of insulin pump therapy, circadian profiles by age group should be taken into account in pediatric patientsto optimize basal rate faster and more easily.