Relationship between glycemic control and different insulin regimens in pediatric type 1 diabetes mellitus

Abstract

Background: Important health issues are diabetes mellitus and its comorbidities. Insulin can be delivered by several regimens including twice daily injections or multiple daily injections. This study aimed to determine what affects the state of glycemic control (age of patient, gender). Patients and methods: A prospective study was conducted in the Department of Pediatrics in Al-Kadhmain Medical City in a period from the 1st of January 2021 to the 31st of June 2021(6 months). Data was collected from their parents or caregivers by direct questionnaire. According to American Diabetes Association criteria, patients were divided into two groups (good glycemic control, and poor glycemic control) and a comparison between insulin regimens was done.Results: Among a total number of 98 children in this study, the mean age ± standard deviation (10.5 ± 3.5) years, 50 of them were newly diagnosed. most of the patients were females 55 (56.1%) versus 43(43.9%) males. There is no significant association between gender and glycemic control. Increasing the age of the patients associated with poor glycemic control, The highest percentage of children with good control was for those on basal regimen. The percentage of children with good control increased with follow-up visits, it starts with only 25.5% in the baseline visit and increased to 75.5% in the third visit. There is a significant difference in the growth parameter with different insulin regimens, the best growth pattern was found in those on basal-bolus, followed by pre-mixed and finally the intermediate (lente) and soluble regimen.Conclusion: Insulin therapy which uses a multiple daily insulin injection regimen has favourable results in children and adolescents with diabetes mellitus type 1 in comparison to a twice insulin injection regimen.