Objective: Initiation of continuous subcutaneous insulin therapy (CSII) requires an appropriate basal rate profile. Although different approaches exist; there is a lack of evidence-based recommendations, especially in young children. Our aim was to show how the % of basal rates change at the end of first year of therapy when basal rates are equally distributed at the start of therapy.
Materials and Methods: In this survey, 129 CSII patients were analyzed. Patients were divided into four age groups: <5 yr (n=27), 5 to < 8 yr (n=20), 8 to <12 yr (n=33), 12 to <15 yr (n=28), 15 to < 18 yr (n=16) and > 18 yr (n=5). Basal insulin requirement and diurnal distribution were evaluated at the initiation of pump therapy and in the first year.
Results: Basal insulin requirement did not differ between the beginning of therapy and first year (Table 1). In every age group basal insulin (U/kg) circadian insulin profiles were different except in the group 12 to <15 yr. As a result, at the start of pump therapy basal rates should be designed according to circadian rhythm.
|Basal İnsulin beginning U/kg||1 st Year Basal insulin U/kg||p|
|05 yr n:27||0.41±0.88||0.26±0.68||0.13|
|58 yr n:20||0.29±0.12||0.30±0.09||0.50|
|812 yr n:33||0.31±0.13||0.32±0.09||0.27|
|1215 yr n:28||0.33±0.08||0.35±0.09||0.34|
|1518 yr n:16||0.32±0.10||0.34±0.11||0.43|
|>18 yr n:5||0.22±0.05||0.24±0.06||0.5|
|p: basal and first year change pa: change according to age groups.|
27 - 29 Sep 2018
European Society for Paediatric Endocrinology