Effect of Insulin Dilution on Lowering Glycemic Variability in Pump-Treated Young Children with Inadequately Controlled Type 1 Diabetes.
BACKGROUND
We investigated whether in young children with inadequately controlled type 1 diabetes and technical problems with continuous subcutaneous infusion of insulin at 100 units/mL the switch to insulin diluted to 10 units/mL (U10) can limit technical problems and improve glycemic control.


METHODS
Diluted U10 insulin was started in three children 3.8, 3.2, and 1.3 years old with a hemoglobin A1c (HbA1c) level (mean±SD) of 8.1±0.17% (65±1.7 mmol/mol) and insulin dose of 8.80±2.93 units/day. Patients were evaluated with continuous glucose monitoring (iPro™2; Medtronic Minimed, Northridge, CA) and a quality of life questionnaire (PedsQL™; www.pedsql.org/ ) and surveyed for pump-related problems at baseline and after 3 and 9 months of U10 insulin therapy.


RESULTS
Continuous glucose monitoring records showed that glycemic variability assessed by SD and M100 decreased significantly (P=0.0085 and P=0.0482, respectively). HbA1c levels dropped to 7.3±1.00% (56±11.0 mmol/mol) after 3 months and to 6.7±0.55% (50±6.1 mmol/mol) after 9 months (P=0.12). Technical difficulties were minimized.


CONCLUSIONS
These results suggest that the use of U10 insulin decreases glycemic variability and improves hampered pump therapy in young children with inadequately controlled type 1 diabetes.
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź , Łódź, Poland .
Beata
B
Mianowska
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź , Łódź, Poland .
Wojciech
W
Fendler
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź , Łódź, Poland .
Bartłomiej
B
Tomasik
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź , Łódź, Poland .
Wojciech
W
Młynarski
Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Łódź , Łódź, Poland .
Agnieszka
A
Szadkowska
D001786:Blood Glucose / Q000187:drug effects; D015190:Blood Glucose Self-Monitoring; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004868:Equipment Failure; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007223:Infant; D055104:Infusions, Subcutaneous / Q000295:instrumentation*; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D010290:Parents / Q000523:psychology; D011788:Quality of Life
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human