Improving the Estimation of Meal-Time Insulin Dose Based On the Glycaemic Load of a Meal in Children with Type 1 Diabetes on Insulin Pump Therapy: A Randomized Study

Aim. To assess dynamics of glycated hemoglobin levels and insulin doses per kg bw in children and adolescents with poorly controlled type 1 diabetes mellitus using insulin pumps. Materials and methods. Retrospective analysis of HbA1c levels and insulin doses per kg bw in children aged 2-17 years with DM1 (mean duration 5.3?3.1) before and 18 months after onset of insulin pump therapy (Medtronic Minimed 712 and 722) with a short-acting insulin analog Novopramid (Novo Nordisk) or Humalog (Ely Lilly) given to 55 (52,4%) and 50 (47,6%) of the patients respectively. НbА1с level and mean daily insulin dose per kg bw were determined when a patient visited the doctors office every 3 months. Results. Insulin pump therapy in patients with initially poorly controlled DM1 resulted in a decrease of HbA1c from 9.8?0.8 to 7,8?0,5% within 18 months after its beginning (p

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Sex differences over time for glycemic control, pump use and insulin dose in patients aged 10–40 years with type 1 diabetes: a diabetes registry study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002494 ◽

2021 ◽

Vol 9 (2) ◽

pp. e002494

Author(s):

Claudia Boettcher ◽

Sascha R Tittel ◽

Thomas Meissner ◽

Bettina Gohlke ◽

Rainer Stachow ◽

...

Keyword(s):

Type 1 Diabetes ◽

Sex Differences ◽

Glycemic Control ◽

Metabolic Control ◽

Insulin Pump ◽

Insulin Dose ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Migrant Background

IntroductionTo evaluate sex differences in people with type 1 diabetes concerning changes in glycemic control and trends in insulin pump use and insulin dose over two decades in adolescents and one-and-a-half decades in adults.Research design and methodsPeople aged 10–20 years (data years 1999–2018) and 21–40 years (data years 2004–2018) with type 1 diabetes were identified in the Diabetes Prospective Follow-up Registry (DPV). All available patients’ data sets of the respective period were used for linear regression analyses to investigate trends in HbA1c, pump use, insulin doses and body mass index SD scores (BMI-SDS) in females and males. In addition, stratification by migrant background was made for the adolescent group.ResultsIn the youth group (n=68 662), both boys and girls showed an HbA1c decrease over the period examined. After stratification for migrant background, an HbA1c convergence between boys and girls was seen in those without migrant background as of 2016. Usage of insulin pumps increased continuously from 3% (boys and girls) to 47% (boys) and 54% (girls), respectively. The daily insulin dose in units per kilogram body weight and day increased continuously from 1999 to 2018. An insulin dose leveling between boys and girls occurred. BMI-SDS consistently increased in girls whereas only slight variations were observed in boys.The adult group (n=15 380) showed constant HbA1c sex differences from 2004 to 2018 with lower HbA1c level in females. The use of insulin pump therapy rose from 18% to 35% (males) and 30% to 50% (females).ConclusionsThe gap in metabolic control between boys and girls with type 1 diabetes seems to close, but predominantly in adolescents without a migrant background. Improved HbA1c was associated with increased insulin pump use, especially in girls.In adult patients, sex differences in metabolic control and insulin pump use persist: women show constantly lower HbA1c values and higher insulin pump use.

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330-OR: A 30% Increased Insulin Dose Is Necessary to Control Postprandial Hyperglycemia for High Protein Meals in Individuals with Type 1 Diabetes Using Insulin Pump Therapy

Diabetes ◽

10.2337/db19-330-or ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 330-OR

Author(s):

MEGAN A. PATERSON ◽

CARMEL E. SMART ◽

JORDAN RAFFERTY ◽

BRETT FENTON ◽

DARRELL PRICE ◽

...

Keyword(s):

Type 1 Diabetes ◽

Insulin Pump ◽

Insulin Dose ◽

Postprandial Hyperglycemia ◽

High Protein ◽

Insulin Pump Therapy ◽

Pump Therapy

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Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes

Journal of Diabetes Research ◽

10.1155/2017/1249729 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Gry Høst Dørflinger ◽

Charlotte Brink Holt ◽

Steffen Thiel ◽

Jakob Appel Østergaard ◽

Troels Krarup Hansen

Keyword(s):

Type 1 Diabetes ◽

Glycaemic Control ◽

Insulin Pump ◽

Insulin Dose ◽

Insulin Pump Therapy ◽

Pump Therapy ◽

Mannan Binding Lectin ◽

Improved Glycaemic Control ◽

Binding Lectin

Objective. Mannan-binding lectin (MBL) concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes. Methods. We measured MBL, fructosamine, and HbA1cat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy. Results. After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, P<0.0001). There was a significant decrease in HbA1c from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, P<0.0001) and in fructosamine levels (from 356 μmol/L to 311 μmol/L, P<0.0001). MBL levels decreased by 10% from 2165 μg/L (IQR 919–3389 μg/L) at baseline to 1928 μ/L (IQR 811–2758 μg/L) at follow-up (P=0.005), but MBL change was not significantly correlated with changes in insulin dose, HbA1c, or fructosamine. Conclusions. MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.

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