title: Prevalence of intentional under- and overdosing of insulin in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prevalence of insulin under- and overdosing in paediatric patients.
  
  
  METHODS
  Cross-sectional study including 241 patients (age 14.0 + 2.7 yr, 42.5% males) with type 1 diabetes from 21 diabetic outpatient clinics. Haemoglobin A1c (HbA1c), height, and weight were available from clinical records. Patients were interviewed with the Diabetes Self-Management Profile (DSMP) interview. T test, U test, and chi-squared test were used for comparison.
  
  
  RESULTS
  On the basis of the DSMP, 103 (42.7%) patients (group A) showed adherence to the therapeutic insulin regimen, while 71 (29.5%) patients (group B) confessed intentional over and/or under-dosing of insulin. Sixty-seven (27.8%) adolescents (group C) reported management problems leading to unintended inappropriate insulin dosages. In group B, 55 (22.8%) injected higher insulin doses and 58 (24.1%) omitted insulin. Patients of group B compared to group A were older 15.0 (±2.5) vs. 14.0 (±2.5) yr (p < 0.01), older at onset 9.5 (±3.6) vs. 8.3 (±3.8) yr (p = 0.05), were more often girls (69 vs. 45.6%), had a higher actual HbA1c (8.7 ± 1.7 vs. 7.8 ± 1.2%), and a higher average HbA1c in the previous year (8.3 ± 1.6 vs. 7.9 ± 1.2%) (p < 0.01). No significant differences could be found between group A and group C.
  
  
  CONCLUSIONS
  Intentional overdosing of insulin is almost as prevalent in children and adolescents as insulin omission. Females are more at risk.
authors: Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria. edith.schober@meduniwien.ac.at
authors: Edith
authors: E
authors: Schober
authors: Gudrun
authors: G
authors: Wagner
authors: Gabriele
authors: G
authors: Berger
authors: Daniela
authors: D
authors: Gerber
authors: Marlene
authors: M
authors: Mengl
authors: Sarah
authors: S
authors: Sonnenstatter
authors: Irene
authors: I
authors: Barrientos
authors: Birgit
authors: B
authors: Rami
authors: Andreas
authors: A
authors: Karwautz
authors: Maria
authors: M
authors: Fritsch
mesh_terms: D000293:Adolescent; D001317:Austria; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin