Changes in insulin therapy regimens over 10 yr in children and adolescents with type 1 diabetes attending diabetes camps

Abstract

A major trend in intensifying insulin treatment in children and adolescents with type 1 diabetes was accompanied by modest improvements in HbA1c. No insulin regimen has shown any better results, except over premixed insulins.

Insulin regimens, diabetes knowledge, quality of life, and HbA1c in children and adolescents with type 1 diabetes

“…The global analysis of the data has shown that the associations between HbA1c and insulin treatment regimens was weak, as previously reported. Regimens using premixed insulin only were still associated with higher mean HbA1c, as in other observational studies , but these regimens almost disappeared in the last few years. No difference was found between basal bolus and other regimens, while mean HbA1c was slightly lower with the pump than with other regimens, but the difference was rather small as also reported in recent meta‐analyses and it did not remain significant in multivariate analysis.…”

“…Therapeutic regimens were classified as previously described , from the association of the different types of insulin at different possible times of injection: fast‐acting insulins (human and analogs), long‐acting insulins (NPH, lantus and levemir), and premixed insulins (premixed analogs with 25, 30, 50, and 70 % fast‐acting analog); breakfast (7–8 h), lunch (around noon), afternoon snack (16–17 h), dinner (19–20 h), and bedtime (around 22 h). This classification previously included six types of therapeutic regimens: pump, basal bolus, injections two to three times per day, premixed insulin only, diverse and inadequate. However, due to their small numbers, inadequate and diverse regimens were pooled for the analysis.…”

A systematic review of non‐genetic predictors and genetic factors of glycated haemoglobin in type 1 diabetes one year after diagnosis

“…The sample size range is 70 to 30 708 patients with a median sample size of 210 T1D patients. Thirty‐two studies were performed in several European countries, 31 in USA, one in Canada, three in Israel, and the rest in other countries (one in Japan, one in New‐Zealand, three in Turkey, one in Australia, and three are multinational). Most studies (54 studies) were performed on T1D children (median of mean age reported in articles 12.5 [range: 4.1‐17.7]), 22 included both children and young adults (median of mean age of 14.8 [range: 10.1‐21.6]), and one included only young adults (mean age of 19.4 ± 0.9 [range: 18‐21]).…”

Diabetes knowledge in adolescents with type 1 diabetes and their parents and glycemic control

“…Glycated hemoglobin (HbA1c) was measured on the same day in the hospital's local laboratory. Therapeutic regimens were classified from the types of insulin at each different time of injection, as previously described: pump, basal‐bolus, injections 2 to 3 times per day, regimens with only premixed insulins, and others. The questionnaire and the file were regularly transmitted to the database center, and the files missing data were completed by phone or by email.…”