Basal and Bolus Insulin Requirements in Children, Adolescents, and Young Adults with type 1 Diabetes Mellitus on Continuous Subcutaneous Insulin Infusion (csii): Effects of age and Puberty

Cemeroğlu, Ayşe Pínar; Thomas, J; Zande, Luke T. Vande; Nguyen, N; Wood, Mark; Kleis, Lora; Davis, Alan T.

doi:10.4158/ep13099.or

Cited by 42 publications

(39 citation statements)

References 23 publications

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“…Our study adds to other reports that showed that various aspects of insulin pump therapy and pump settings have significant effect on metabolic control such as timing of bolus , number of boluses , use of different type of bolus and carbohydrate counting by bolus‐calculator . In addition, different studies have studied the optimal basal insulin rates in children and our findings support the tendency in clinical practice to aim for lowest age dependent basal dose settings for children on CSII in order to optimize glycaemic control and to decrease risks of micro‐vascular complications , .…”

Section: Discussionsupporting

confidence: 80%

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Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

et al. 2016

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Section: Discussionsupporting

confidence: 80%

“…Initially, basal insulin secretion was set on approximately 50% of the total insulin dose based on estimates in a healthy pancreas under normal conditions . Present recommendations are based on the estimated food‐independent insulin requirements, compromising 30–50% of the total insulin dose .…”

mentioning

confidence: 99%

Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

et al. 2016

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“…The amount of insulin needed to maintain glycemic control increases in puberty [6] and with longer T1D duration and older age [7]. The DCCT—Epidemiology of Diabetes Interventions and Complications (EDIC) study also demonstrated that increased insulin needs are associated with more T1D complications [8, 9] and weight gain and higher weight status across time in individuals with T1D [10–12, 13••] because of the anabolic and lipogenic actions of insulin [14].…”

Section: The Role Of Insulin In Weight Gainmentioning

confidence: 99%

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

et al. 2017

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Purpose of Review This review aims to summarize the type 1 diabetes (T1D) and weight literature with an emphasis on barriers associated with weight management, the unique T1D-specific factors that impact weight loss success, maladaptive and adaptive strategies for weight loss, and interventions to promote weight loss. Recent Findings Weight gain is associated with intensive insulin therapy. Overweight and obese weight status in individuals with T1D is higher than the general population and prevalence is rising. A variety of demographic (e.g., female sex), clinical (e.g., greater insulin needs), environmental (e.g., skipping meals), and psychosocial (e.g., depression, stress) factors are associated with overweight/obese weight status in T1D. Fear of hypoglycemia is a significant barrier to engagement in physical activity. Studies evaluating adaptive weight loss strategies in people with T1D are limited. Summary There is a growing literature highlighting the prevalence and seriousness of overweight and obesity among both youth and adults with T1D. There is an urgent need to develop evidence-based weight management guidelines and interventions that address the unique concerns of individuals with T1D and that concurrently address glycemic control.

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“…The pediatric population presents additional challenges to the system due to differences in insulin sensitivity in children of varying ages (9), with younger children being more insulin sensitive and adolescents demonstrating insulin resistance (10). …”

Section: Introductionmentioning

confidence: 99%

Overnight Glucose Control With an Automated, Unified Safety System in Children and Adolescents With Type 1 Diabetes at Diabetes Camp

et al. 2014

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OBJECTIVETo determine the safety and efficacy of an automated unified safety system (USS) in providing overnight closed-loop (OCL) control in children and adolescents with type 1 diabetes attending diabetes summer camps.RESEARCH DESIGN AND METHODSThe Diabetes Assistant (DIAS) USS used the Dexcom G4 Platinum glucose sensor (Dexcom) and t:slim insulin pump (Tandem Diabetes Care). An initial inpatient study was completed for 12 participants to evaluate safety. For the main camp study, 20 participants with type 1 diabetes were randomized to either OCL or sensor-augmented therapy (control conditions) per night over the course of a 5- to 6-day diabetes camp.RESULTSSubjects completed 54 OCL nights and 52 control nights. On an intention-to-treat basis, with glucose data analyzed regardless of system status, the median percent time in range, from 70–150 mg/dL, was 62% (29, 87) for OCL nights versus 55% (25, 80) for sensor-augmented pump therapy (P = 0.233). A per-protocol analysis allowed for assessment of algorithm performance. The median percent time in range, from 70–150 mg/dL, was 73% (50, 89) for OCL nights (n = 41) versus 52% (24, 83) for control conditions (n = 39) (P = 0.037). There was less time spent in the hypoglycemic range <50, <60, and <70 mg/dL during OCL compared with the control period (P = 0.019, P = 0.009, and P = 0.023, respectively).CONCLUSIONSThe DIAS USS algorithm is effective in improving time spent in range as well as reducing nocturnal hypoglycemia during the overnight period in children and adolescents with type 1 diabetes in a diabetes camp setting.

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Basal and Bolus Insulin Requirements in Children, Adolescents, and Young Adults with type 1 Diabetes Mellitus on Continuous Subcutaneous Insulin Infusion (csii): Effects of age and Puberty

Cited by 42 publications

References 23 publications

Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

Lower dose basal insulin infusion has positive effect on glycaemic control for children with type I diabetes on continuous subcutaneous insulin infusion therapy

Biopsychosocial Aspects of Weight Management in Type 1 Diabetes: a Review and Next Steps

Overnight Glucose Control With an Automated, Unified Safety System in Children and Adolescents With Type 1 Diabetes at Diabetes Camp

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