ESPE Abstracts (2015) 84 P-3-752

The Long-Term Insulin Management with Premixed Insulin in Neonates and Infants with Diabetes

Hakan Doneraya & Muhammet Oktay Yalcinozb


aAtaturk University Faculty of Medicine Department of Pediatric Endocrinology, Erzurum, Turkey; bAtaturk University Faculty of Medicine Department of Pediatrics, Erzurum, Turkey


Objectives: To describe a new therapy protocol for the long-term insulin management in neonates and infants with diabetes.

Methods: All the infants were fed with 3 hours intervals. The patients were started insulin therapy with 0.6 U/kg per day divided equally into four doses. All the insulin doses were given as premixed insulin (25% insulin lispro and 75% neutral protamine Hagedorn (NPH) insulin) when the number of breast feed was more than three during the night, while if the patient had less than three breast feeds, only the last insulin (night) dose was administered as NPH insulin. Nine-point plasma glucose profiles, HbA1c, and the weight gain were evaluated at the last visit.

Results: The study was completed with 11 patients who had neonatal diabetes (ND) or type 1 diabetes (T1D). During the follow-up, all the patients had enough weight and length gain, and none of them had episode of ketoacidosis. None of the patients had rapid fluctuations for the blood glucose levels. Hypoglycaemia, normoglycaemia and hyperglycaemia were reported by 8%, 81%, and 11% of all the blood glucose measurements, respectively. Severe hypoglycaemia was not experienced by any patients. The mean HbA1c levels of the patients with ND and T1D at the last visit were %7.0±0.2 and 7.6±0.55, respectively.

Conclusion: This study describes a specific protocol for long-term insulin management of neonates and infants with diabetes. The findings suggest that the method is effective, convenient, and successful.

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