Insulin doses in children using conventional therapy for insulin dependent diabetes

Kerouz, Nada; El-Hayek, Roque; Langhough, Rebecca; MacDonald, Michael J.

doi:10.1016/0168-8227(95)01122-6

Cited by 20 publications

(15 citation statements)

References 5 publications

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“…In fact, most of our children had short stature, which was more pronounced in puberty, in accordance with other studies (25,26). At variance (27,28), there was no correlation between growth and duration of diabetes or insulin requirement (18,21); however, we cannot rule out the contribution of other well-known factors such as malnutrition and chronic infections.…”

supporting

confidence: 79%

Survey on Acute and Chronic Complications in Children and Adolescents With Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania

et al. 2007

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OBJECTIVE -The purpose of this study was to assess glycemic control and complications of type 1 diabetes in children and adolescents in Tanzania. RESEARCH DESIGN AND METHODS -This demographic and clinical survey in-cluded 99 children aged between 5 and 18 years attending Muhimbili National Hospital Clinic for Diabetes. A structured questionnaire was used for evaluating socioeconomic data and for estimation of the prevalence of acute complications occurring over the last 6 months. The prevalences of retinopathy and diabetic nephropathy were determined by fundus ophthalmoscopy and by microalbuminuria, respectively.RESULTS -All of these children were treated with a conventional insulin regimen. The mean Ϯ SD duration of diabetes was 4.76 Ϯ 3.58 years. Only 1 child (1%) had good glycemic control (A1C Ͻ7.5%), 60 children (60.6%) had moderate glycemic control (A1C 7.5-10%), 14 children (14.1%) had poor glycemic control (A1C Ͼ10 -12.5%), and 24 children (24.2%) had very poor glycemic control (A1C Ͼ12.5%). At onset of diabetes, 75% of children presented with diabetic ketoacidosis (DKA); 89 children (89.80%) had at least one episode of DKA, and 55 children (55.67%) had symptomatic hypoglycemic episodes. Microalbuminuria was present in 29 (29.3%) and retinopathy in 22 (22.68%) children.CONCLUSIONS -Although there are some methodological limitations, this survey highlights the difficulties of achieving good metabolic control and the high prevalence of acute and chronic complications in Tanzanian children with type 1 diabetes. These results clearly show that major efforts are needed to improve quality of care in children with type 1 diabetes in Tanzania. Diabetes Care 30:2187-2192, 2007T ype 1 diabetes is one of the most frequent chronic disease in children and represents a public health challenge globally. Its burden is huge in developing countries owing to the lack of a basic means for reaching reasonable glycemic control. Because of the unavailability of reliable epidemiological data, the natural history of type 1 diabetes, including its complications, is largely unknown (1). With the few data available on subSaharan African children, incidence in Tanzania was estimated to be 1.5/ 100,000 (2), and an increase in incidence in Sudan from 9.5/100,000 in 1991 to 10.3/100,000 in 1995 has been reported (3). The prevalence is higher in Western countries (4,5), suggesting the possibility of missed diagnosis in sub-Saharan Africa. In fact, the problem of missed diagnosis of childhood diabetes, although not unique to developing countries (6), is certainly much more common than in developed countries (7). In a Sudanese study, it was reported that 10% of children were not admitted at the time of diagnosis, being admitted only after they developed diabetic ketoacidosis (DKA) or hypoglycemia (3). This situation contributes to omission of patients in the registry as well as to the possibility of death before diagnosis, especially for those aged Ͻ5 years. In sub-Saharan Africa, most children present with DKA at the time of diagnosis (8,...

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confidence: 79%

Survey on Acute and Chronic Complications in Children and Adolescents With Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania

et al. 2007

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“…In fact, the insulin requirement ranges from about 0.5-0.7 U=kg=day in prepubertal to !1.5 U=kg=day in pubertal patients. 14,15 Insulin resistance and the particular expressivity of the ''dawn'' phenomenon, due to hormonal changes (increased secretion of growth hormones, sex steroid hormone production, etc. ), are typical of those of pubertal age.…”

Section: Introductionmentioning

confidence: 99%

Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Shashaj

Sulli

2009

Diabetes Technology & Therapeutics

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“…Metabolic control in patients with T1DM is often impaired during puberty and adolescence, a phenomenon that has been ascribed to increased growth hormone secretion [4,5]. Girls with T1DM display poorer glycemic control than boys with the same disease [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Menarcheal age of type 1 diabetic Bengali Indian females

Raha

Sarkar

Gódi

et al. 2013

Gynecological Endocrinology

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Insulin doses in children using conventional therapy for insulin dependent diabetes

Cited by 20 publications

References 5 publications

Survey on Acute and Chronic Complications in Children and Adolescents With Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania

Survey on Acute and Chronic Complications in Children and Adolescents With Type 1 Diabetes at Muhimbili National Hospital in Dar es Salaam, Tanzania

Difference in Insulin Usage Patterns with Pubertal Development in Children with Type 1 Diabetes During Transition from Multiple Daily Injections to Continuous Subcutaneous Insulin Infusion (CSII) and Through the CSII Treatment

Menarcheal age of type 1 diabetic Bengali Indian females

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