Mealtime Bolus Insulin Dose Timing in Children with Type 1 Diabetes: Reallife Data from a Tertiary Care Centre in Northern India

Rohilla, Latika; Dayal, Devi; Gujjar, Neetu; Walia, Priyanka; Kumar, Rajesh; Yadav, Jaivinder

doi:10.4183/aeb.2021.528

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…A final number of 13 studies were included in this systematic review. A summary of studies along with the grading of evidence are reported in Table 1 [10,[16][17][18][19][20][21][22][23][24][25][26]. A final number of 13 studies were included in this systematic review.…”

Section: Evidence From Clinical Studiesmentioning

confidence: 99%

Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review

Mozzillo¹,

Franceschi

Candia³

et al. 2022

JPM

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The aim of this systematic review was to report the evidence on optimal prandial timing of insulin bolus in youths with type 1 diabetes. A systematic search was performed including studies published in the last 20 years (2002–2022). A PICOS framework was used in the selection process and evidence was assessed using the GRADE system. Up to one third of children and adolescents with type 1 diabetes injected rapid-acting insulin analogues after a meal. Moderate–high level quality studies showed that a pre-meal bolus compared with a bolus given at the start or after the meal was associated with a lower peak blood glucose after one to two hours, particularly after breakfast, as well as with reduced HbA1c, without any difference in the frequency of hypoglycemia. There were no differences related to the timing of bolus in total daily insulin and BMI, although these results were based on a single study. Data on individuals’ treatment satisfaction were limited but did not show any effect of timing of bolus on quality of life. In addition, post-prandial administration of fast-acting analogues was superior to rapid-acting analogues on post-prandial glycemia. There was no evidence for any difference in outcomes related to the timing of insulin bolus across age groups in the two studies. In conclusion, prandial insulin injected before a meal, particularly at breakfast, provides better post-prandial glycemia and HbA1c without increasing the risk of hypoglycemia, and without affecting total daily insulin dose and BMI. For young children who often have variable eating behaviors, fast-acting analogues administered at mealtime or post-meal could provide an additional advantage.

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Section: Evidence From Clinical Studiesmentioning

confidence: 99%

Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review

Mozzillo¹,

Franceschi

Candia³

et al. 2022

JPM

View full text Add to dashboard Cite

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Caregivers’ knowledge and medication adherence in children with thyroid disorders: an exploratory study

Gujjar,

Verma,

Rohilla

et al. 2023

Journal of Pediatric Endocrinology and Metabolism

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Objectives Many thyroid disorders in children demand long-term therapy. The parent’s understanding of the child’s condition is of utmost importance for adherence to treatment. The study objective was to assess the knowledge, medication adherence, reasons for non-adherence, and their relationship with various clinical parameters. Methods An exploratory, cross-sectional study with a total enumeration sampling technique was conducted between July 2022 and September 2022. Children and young adults aged ≤18 years who were diagnosed with a thyroid disorder and taking medications for at least 3 months were included. Data were collected by interviewing parents using the Adherence to Refills and Medications Scale (ARMS) and structured knowledge questionnaire. Results Parents of 102 children were interviewed. The mean age of the children was 9.2 ± 0.4 years; 58 (57 %) were girls. The mean duration of treatment was 5.5 ± 0.3 years. Many (66 %) informants were mothers. Three-fourths (75.5 %) of parents were educated up to senior secondary and above. Most (91.2 %) of parents had poor knowledge about the disease and its management. Poor disease knowledge was significantly linked to lower education (p<0.001). Nonetheless, strong adherence (>80 %) was noted on the ARMS scale. No significant correlation was found between physical growth, thyroid function, and adherence/knowledge (p-values 0.20–0.71). Conclusions The caregivers’ knowledge of thyroid disorders was poor and related to their educational level. There is a need to use clear language and ensure that parents have an adequate understanding of their child’s condition. Healthcare professionals should assess and address gaps in parental knowledge and adherence.

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Mealtime Bolus Insulin Dose Timing in Children with Type 1 Diabetes: Reallife Data from a Tertiary Care Centre in Northern India

Cited by 2 publications

References 14 publications

Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review

Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review

Caregivers’ knowledge and medication adherence in children with thyroid disorders: an exploratory study

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