title: Insulin requirement in preschoolers treated with insulin pumps at the onset of type 1 diabetes mellitus.
abstract: OBJECTIVE
  The aim of this study is to analyze changes in the basal insulin requirement in preschoolers treated with insulin pump at the onset of T1DM, using system to calculate meal time insulin.
  
  
  METHODS
  58 children (31 girls) under 6 years (mean age 3.3 +/- 1.5 years) initiated on insulin pump therapy within 2 months after recognition of T1DM and treated at least for 1 year were analyzed during a follow-up period of 165 patient-years. Data was collected every 6 months: HbA1c, BMI SDS, diabetic ketoacidosis, severe hypoglycaemia, total daily insulin dose (TDD) and basal insulin.
  
  
  RESULTS
  Basal insulin rose from 10% in the third month and did not exceed 30% of TDD after 12 months (p<0.0001). In the third month, 46% of children were without basal insulin; this group included significantly older children (3.7 +/- 1.4 vs. 2.8 +/- 1.4 years; p = 0.01), which had lower TDD (0.33 +/- 0.18 vs. 0.54 +/- 0.23 u/kg/d; p = 0.0007) than children with basal insulin. HbA1c persisted < or =7.3%.
  
  
  CONCLUSIONS
  In preschool children initiated on CSII therapy at the time of T1DM diagnosis the first year of treatment is critical for altering the basal insulin dose. Preschoolers with TDD lower than 0.5 U/kg/d may not require basal insulin. Moreover, basal insulin did not exceed 30% of TDD in the first years after T1DM onset.
authors.affiliation: Medical University of Warsaw, The Second Department of Paediatrics, Poland. agnieszka.szypowska@gmail.com
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Szypowska
authors.forename: Maria
authors.initials: M
authors.lastname: Lipka
authors.forename: Marlena
authors.initials: M
authors.lastname: Błazik
authors.forename: Lidia
authors.initials: L
authors.lastname: Groele
authors.forename: Ewa
authors.initials: E
authors.lastname: Pańkowska
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007223:Infant; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D012016:Reference Values; D012074:Remission Induction; D012189:Retrospective Studies
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin