Patterns of insulin therapy and insulin daily doses in children and adolescents with type 1 diabetes in Germany

Abstract

Aim To describe the different insulin therapy patterns and insulin daily doses in children and adolescents (aged 1‐17 years) with type 1 diabetes. Methods This cross‐sectional study based on the longitudinal prescription (LRx) database (IQVIA) included children and adolescents who received at least two insulin prescriptions of the same drug from 1 January 2016 to 31 December 2019. The study outcomes included the proportion of patients with insulin pumps and multiple daily injection therapy, human insulin and insulin analogue use, as well as insulin daily doses. A multivariable linear regression model was used to study the association between age, sex, insulin drugs, and daily dose. Results A total of 22 512 children and adolescents (mean age: 13.5 years, 47.1% female) were included. The proportion of patients using insulin pump therapy decreased with age, from 72.6% (females) and 73.0% (males) in the age group of younger than 6 years to 30.8% (females) and 26.1% (males) in adolescents. Insulin aspart was the most common short‐acting insulin, with the proportion of users increasing from 56% in the age group of younger than 6 years to 69%‐70% in the 13‐17 years age group. The daily dose of insulin pump therapy was 10 units lower than multiple daily injection (MDI) (P < .001). Conclusion We found a marked age dependency for pump use, with a strong increase observed in the youngest age group. Insulin aspart was the most frequently used analogue insulin. A higher total daily insulin dose was shown in patients on MDI versus insulin pump, along with a significant age dependency.

Early Retinal Microvascular Changes Assessed with Swept-Source OCT Angiography in Type 1 Diabetes Patients without Retinopathy

“…Similar results in the literature showed a positive correlation between the total daily insulin intake and ganglion cell complex thickness [ 25 ]. A high total daily insulin intake is a surrogate for intensive treatment, linked to a long-term beneficial effect on vascular damage [ 26 , 27 , 28 ]. Regarding the glycemic control analysis through the HbA1c and MAGE assessment, it is essential to remember that these parameters only reflect the last few days to months of the glucose balance.…”

Effect of Shot Blockers versus Buzzy Bee Distractor on Relieving Pain and Anxiety Level during Insulin Injection among Children with Type I Diabetes

“…The use of nonpharmacological measures has increased to reduce pain. (25,26) The non-pharmacological measures such as shot blocker and buzzy bee are safer than pharmacological measures and have fewer or no side effects. Shot blocker includes a number of short, blunt skin contact points on its underside and a centrally located opening through which injections are administered.…”

Factors Affecting Performance of Insulin Pen Injector Technology: A Narrative Review

“…Moreover, the daily dose of insulin needed for each person can vary greatly, depending on body weight and insulin sensitivity. 71 -74 Over the past 35 years, technological innovations have enabled the design of accurate pen injectors with small, single-use needles and low manual injection force to improve the overall injection experience for individuals, 75 with improved accuracy and reproducibility of the delivery of insulin doses, including small doses, compared with vial and syringe. 76 -79 Asakura et al 36 reported that using a pen injector was more accurate than vial and syringe regardless of HCP experience in insulin therapy.…”