Initial insulin therapy in children and adolescents with type 1 diabetes mellitus

  1. Dieter Weitzela1,
  2. Ulla Pfeffera1,*,
  3. Axel Dost2,
  4. Antje Herbstc3,
  5. Ina Knerr4,
  6. Reinhard Holl5

Article first published online: 25 AUG 2009

DOI: 10.1111/j.1399-5448.2009.00562.x

Issue

Pediatric Diabetes

Pediatric Diabetes

Volume 11, Issue 3, pages 159–165, May 2010

Additional Information

How to Cite

Weitzela, D., Pfeffera, U., Dost, A., Herbstc, A., Knerr, I. and Holl, R. (2010), Initial insulin therapy in children and adolescents with type 1 diabetes mellitus. Pediatric Diabetes, 11: 159–165. doi: 10.1111/j.1399-5448.2009.00562.x

Author Information

  1. 1

    German Clinic for Diagnostic, Children's and Adolescent's Outpatient Centre, Wiesbaden, Germany

  2. 2

    Children's and Adolescent's University Hospital, Jena, Germany

  3. 3

    Klinikum Leverkusen, Children's Departement, Germany

  4. 4

    Children's and Adolescent's University Hospital, Erlangen, Germany

  5. 5

    University of Ulm, Institute of Epidemiology, Ulm, Germany

*Ulla Pfeffer, German Clinic for Diagnostic Children's and Adolescent's Outpatient Centre, Aukammallee 33, D-65191 Wiesbaden, Germany. Tel: 0049-611-577558; fax: 0049-611-577557; e-mail: ulla.pfeffer@gmx.de

Publication History

  1. Issue published online: 27 APR 2010
  2. Article first published online: 25 AUG 2009
  3. Submitted 18 August 2008. Accepted for publication 12 June 2009

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Keywords:

  • Initial insulin therapy;
  • children and adolescents with diabetes;
  • predicitive factors of initial insulin requirements in type 1 diabetes

Weitzel D, Pfeffer U, Dost A, Herbst A, Knerr I, Holl R. Initial insulin therapy in children and adolescents with type 1 diabetes mellitus.

Objective: The aim of the study was to define parameters that influence the initial insulin dosage in young subjects with type 1 diabetes regarding the amount of daily insulin, the ratios of basal and prandial insulin, and the insulin/carbohydrate ratios.

Study design: We used a computer-based registry (with prospectively collected data) in Germany and Austria, a software for the management and data documentation of diabetic patients (DPV), to analyze the initial insulin therapy in 2247 children with newly diagnosed type 1 diabetes to identify factors that influence diabetes therapy within the first 10 d.

Results: For both genders, glucosylated hemoglobin A1c (HbA1c), blood pH at diabetes onset, and pubertal status are the major factors determining the initial insulin dosage calculated as the amount of daily insulin per kilogram body weight (kg), the basal and prandial insulin dose per kilogram, and day and the insulin/carbohydrate ratios for meals. The frequency of hypoglycemia correlated with increasing quotient of applied to calculated insulin dosage.

Conclusion: The predictive factors of insulin requirement may exert beneficial effects on the assessment and adjustment of insulin therapy in young diabetic subjects at disease onset. On the basis of a multiple, linear regression, we suggest a formula to calculate the initial insulin therapy.

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