Proportion of Basal to Total Insulin Dose Is Associated with Metabolic Control, Body Mass Index, and Treatment Modality in Children with Type 1 Diabetes—A Cross-Sectional Study with Data from the International SWEET Registry - 21/11/19
, Esben Thyssen Vestergaard, PhD 2, 3, Anke Schwandt, MS 4, 5, Jacques Beltrand, PhD 6, Birgit Rami-Merhar, MD 7, Stephen M.P. O'Riordan, PhD 8, Przemyslawa Jarosz-Chobot, PhD 9, Cintia Castro-Correia, PhD 10, Evelien F. Gevers, PhD 11, 12, Niels H. Birkebæk, PhD 3Abstract |
Objectives |
To investigate in a large population the proportion of daily basal insulin dose (BD) to daily total insulin dose (TD) (BD/TD) and its association with glycated hemoglobin A1c (HbA1c), body mass index (BMI)- SDS, and treatment modality in children with type 1 diabetes.
Study design |
Cross-sectional study in subjects with type 1 diabetes, age ≤18 years, and ≥2 years of diabetes duration, registered in the international multicenter Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference registry in March 2018. Variables included region, sex, age, diabetes duration, treatment modality (multiple daily injections [MDI] or continuous subcutaneous insulin infusion [CSII]), self-monitoring blood glucose, HbA1c, BD/TD, and BMI-SDS. BMI was converted to BMI-SDS using World Health Organization charts as reference. Hierarchic linear regression models were applied with adjustment for age, sex, and diabetes duration.
Results |
A total of 19 687 children with type 1 diabetes (49% female, 49% CSII users) with median age 14.8 (11.5; 17.2) years and diabetes duration 6.0 (3.9; 9.0) years were included. HbA1c was 63 (55; 74) mmol/mol (7.9 [7.2; 8.9]%), and BMI-SDS 0.55 (−0.13; 1.21). Unadjusted, a lower BD/TD was associated with lower HbA1c, male sex, younger age, shorter diabetes duration, lower BMI-SDS, higher numbers of self-monitoring blood glucose and CSII (all P < .01). After adjustment for confounders, lower BD/TD was associated with lower HbA1c (P < .01) and lower BMI-SDS (P < .01) in children on CSII, but not on MDI.
Conclusions |
Lower BD/TD is positively associated with lower HbA1c and lower BMI-SDS in children with type 1 diabetes on CSII. It remains to be investigated in a prospective study whether reducing BD/TD insulin will improve metabolic control and normalize body weight in children with type 1 diabetes.
Le texte complet de cet article est disponible en PDF.Keywords : HbA1c, BMI-SDS, adolescents, multiple daily injections, continuous subcutaneous insulin infusion
Abbreviations : BD, BD/TD, CSII, HCL, MDI, SMBG, SWEET, TD
Plan
| The work of SWEET is possible through the support of the following corporate sponsors: Abbott, United States; Boehringer Ingelheim, Germany; DexCom Inc; Insulet; Lilly Diabetes Excellent Center; Medtronic Europe; Sanofi, France (sweet-corporate-members.php). The authors declare no conflicts of interest. |
Vol 215
P. 216 - décembre 2019 Retour au numéro
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