ESPE Abstracts (2019) 92 P2-80

Effect of Multiple dose Insulin on Glycaemic Control and Adiposity in Children and Adolescents with Type 1 Diabetes; a Sri Lankan Experience

Raihana Hashim, Thabitha Hoole, Dilusha Prematilake, Udeni Kollurage, Buddi Gunasekara, Janani Suntharesan, Navoda Atapattu

Lady Ridgeway Hospital, Colombo, Sri Lanka

Objective: To describe the glycaemic control and change in body mass index (BMI) in children and adolescents with type 1 diabetes (T1DM) after converting to multiple dose insulin regime (MDI) from fixed dose insulin regime (FD).

Methods: A retrospective observational study on children with T1DM who were converted to MDI from FD at the Lady Ridgeway Hospital from January 2013 to June 2018. Mean haemoglobin A1c(HbA1c) was compared at the initiation of MDI, after 6 months, after 1 year and in January 2019. Change in adiposity was measured by BMI standard deviation scores (BMI SDS) which was compared at the initiation of MDI and in January 2019.

Results: Forty-five (19 male) children who were converted to MDI were studied. Mean ages at initiation and in January 2019 were 10.5 years (range 3.5 to 14.3) and 14.3 years (range 8 to 18) respectively. The follow up period varied from 6 months to 4 years and nine months. Mean HbA1C at initiation (9.6%) had decreased to 8.4% (P<0.01), 8.3% (P<0.001) and 8.7% (P<0.01) at 6 months, at 1 year and in January 2019 respectively. All HbA1C changes were statistically significant. The difference in BMI SDSs at initiation and in January 2019 was not statistically significant (P=0.076).

Conclusions: A significant improvement in glycaemic control was seen 6 months after converting to multiple daily insulin regime, and the improvement was sustained even after a mean duration of 3.5 years. Significant change in adiposity following initiation of MDI was not observed.

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