Impact of the type of Insulin Regimen on Blood Glucose Trends and Frequency of Readmission among Children with Type 1 Diabetes: A Retrospective Study

Abstract

Introduction: Type 1 diabetes mellitus (T1DM) is one of  most common endocrine diseases in children and adolescents. An effective insulin regimen can help keep blood sugar levels close to normal. Insulin therapy is essential in regulating body's glucose levels. This retrospective study has been conducted to understand better how different insulin regimens affect biochemical parameters in type 1 diabetic children, such as HbA1c and 24 h-glucose values.

Materials and Methods: The secondary data gathered from medical records of 48 children with Type 1 Diabetes Mellitus between ages of 2 and 18 who were hospitalized at R.L. Jalappa Hospital and Research Centre, SDUAHER, Tamaka, Kolar, between January 1, 2016, and December 31, 2020.

Results: The 48 children with Type 1 diabetes were hospitalized during this time. Of these, 42% are male and 58% female participants.16% of children had mild diabetic ketoacidosis, 21% had severe cases, 6% had moderate and 5% had co-morbid conditions, 6 were early childhood, 15 were mid-childhood children and 23 were early adolescents. Participants were administered an insulin regimen, of which 11 were on basal-bolus regimen, 27 were on premix regimen, and six were on fixed-dose regimen.

Conclusion: Insulin therapies are now able to more closely mimic physiologic insulin secretion and thus achieve better glycemic control in patients with diabetes. While comparing fixed proportions of mixed insulins and premix regimens and their less physiologic action, there is an increased risk of hypoglycemia using these insulin preparations compared to basal and pre-meal bolus insulin regimen.