Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus

AIM: This study was aimed at investigation of daily glycemic variations in children and adolescents with type 1 diabetes mellitus (T1DM) on continuous subcutaneous insulin infusion (CSII) in order to define in greater detail the correlation of said parameters with periods of age to...

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Autores principales:	Dmitriy Nikitich Laptev, Yury Ivanovich Filippov, Andrey Olegovich Emel'yanov, Tamara Leonidovna Kuraeva
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2013
Materias:	diabetes mellitus insulin pump therapy csii bolus wizard carbohydrate ratio insulin sensitivity factor basal profile Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/f8721f0197ec4fe084491e9f06fffe45
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spelling	oai:doaj.org-article:f8721f0197ec4fe084491e9f06fffe452021-11-14T09:00:18ZAge-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus2072-03512072-037810.14341/2072-0351-98https://doaj.org/article/f8721f0197ec4fe084491e9f06fffe452013-09-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/98https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378AIM: This study was aimed at investigation of daily glycemic variations in children and adolescents with type 1 diabetes mellitus (T1DM) on continuous subcutaneous insulin infusion (CSII) in order to define in greater detail the correlation of said parameters with periods of age to the end of improving current recommendations for pump settings adjustment. MATERIALS AND METHODS: 138 children and adolescents aged 1?18 years on CSII therapy took part in this study. Patients were subdivided into three groups according to their age: preschool children (n=23), prepubertal children aged <12 years (n=39) and teenagers up to 18 years old (n=76). CSII regimens were analyzed in every group, including average daily insulin dose, basal-to-bolus ratio, daily basal profiles, carbohydrate ratio (CR) and insulin sensitivity factor (ISF). RESULTS: Daily requirement for both basal and bolus insulin does differ between ages. Youngest children require higher basal infusion rate during evening hours and first half of the nighttime while demonstrating least requirement at daytime. Instead, prepubertal children and adolescents require higher basal infusion rate during early morning hours. We also show CR and ISF to be dependent of daytime in all studied age grades. CONCLUSIONS: Basal-to-bolus ratio along with circadian variability in requirement for insulin are clearly governed by patient's age. Importantly, the ratios for bolus calculations, developed from our data, significantly differ from those provided by popular formulas, suggesting the latter be modified into taking regard of the age grade for proper individual adjustment of pump settings.Dmitriy Nikitich LaptevYury Ivanovich FilippovAndrey Olegovich Emel'yanovTamara Leonidovna KuraevaEndocrinology Research Centrearticlediabetes mellitusinsulin pump therapycsiibolus wizardcarbohydrate ratioinsulin sensitivity factorbasal profileNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 16, Iss 3, Pp 109-115 (2013)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus insulin pump therapy csii bolus wizard carbohydrate ratio insulin sensitivity factor basal profile Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus insulin pump therapy csii bolus wizard carbohydrate ratio insulin sensitivity factor basal profile Nutritional diseases. Deficiency diseases RC620-627 Dmitriy Nikitich Laptev Yury Ivanovich Filippov Andrey Olegovich Emel'yanov Tamara Leonidovna Kuraeva Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
description	AIM: This study was aimed at investigation of daily glycemic variations in children and adolescents with type 1 diabetes mellitus (T1DM) on continuous subcutaneous insulin infusion (CSII) in order to define in greater detail the correlation of said parameters with periods of age to the end of improving current recommendations for pump settings adjustment. MATERIALS AND METHODS: 138 children and adolescents aged 1?18 years on CSII therapy took part in this study. Patients were subdivided into three groups according to their age: preschool children (n=23), prepubertal children aged <12 years (n=39) and teenagers up to 18 years old (n=76). CSII regimens were analyzed in every group, including average daily insulin dose, basal-to-bolus ratio, daily basal profiles, carbohydrate ratio (CR) and insulin sensitivity factor (ISF). RESULTS: Daily requirement for both basal and bolus insulin does differ between ages. Youngest children require higher basal infusion rate during evening hours and first half of the nighttime while demonstrating least requirement at daytime. Instead, prepubertal children and adolescents require higher basal infusion rate during early morning hours. We also show CR and ISF to be dependent of daytime in all studied age grades. CONCLUSIONS: Basal-to-bolus ratio along with circadian variability in requirement for insulin are clearly governed by patient's age. Importantly, the ratios for bolus calculations, developed from our data, significantly differ from those provided by popular formulas, suggesting the latter be modified into taking regard of the age grade for proper individual adjustment of pump settings.
format	article
author	Dmitriy Nikitich Laptev Yury Ivanovich Filippov Andrey Olegovich Emel'yanov Tamara Leonidovna Kuraeva
author_facet	Dmitriy Nikitich Laptev Yury Ivanovich Filippov Andrey Olegovich Emel'yanov Tamara Leonidovna Kuraeva
author_sort	Dmitriy Nikitich Laptev
title	Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
title_short	Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
title_full	Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
title_fullStr	Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
title_full_unstemmed	Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
title_sort	age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus
publisher	Endocrinology Research Centre
publishDate	2013
url	https://doaj.org/article/f8721f0197ec4fe084491e9f06fffe45
work_keys_str_mv	AT dmitriynikitichlaptev ageadjustmentofinsulinpumpsettingsinchildrenandadolescentswithtype1diabetesmellitus AT yuryivanovichfilippov ageadjustmentofinsulinpumpsettingsinchildrenandadolescentswithtype1diabetesmellitus AT andreyolegovichemelyanov ageadjustmentofinsulinpumpsettingsinchildrenandadolescentswithtype1diabetesmellitus AT tamaraleonidovnakuraeva ageadjustmentofinsulinpumpsettingsinchildrenandadolescentswithtype1diabetesmellitus
_version_	1718429626829635584

Age-adjustment of insulin pump settings in children and adolescents with type 1 diabetes mellitus

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