June 20, 2013

T1D Insulin Requirements in Asolescents

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basal-doseThe official journal of American College of Endocrinology and American Association of Clinical Endocrinologists published a rule of thumb to estimating the basal and bolus rates for T1D adolescents. 

Insulin dosing includes insulin to carbohydrate ratio (I/C), insulin sensitivity factor (ISF) and basal/bolus ratio. There is no magic equation that works, all the time. Your best bet is to get a ballpark figure and tweak it from there.

This study determines the proper settings for subcutaneous insulin infusion in children with T1D, at different ages. T1D patents, ages 3-21 years were analyzed. Participants in this study were not in the “honeymoon” period of T1D. They were veterans on the block, and had been stabilized in the insulin dosing.

The participants were categorized in 8 groups according to age, gender, and/or pubertal stage. Insulin requirements increased with puberty in both sexes. Basal insulin requirement was lowest in the youngest group. The youngest group had the lowest I/C. Insulin sensitivity was higher compared with oldest group

At the end of the study, researchers found that dose calculations vary with age and pubertal status in children with T1D. Most importantly, these differences must be considered when calculating pump dosing, especially for younger children.

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