Optimum bolus wizard settings in insulin pumps in children with Type 1 diabetes

TY - JOUR

T1 - Optimum bolus wizard settings in insulin pumps in children with Type 1 diabetes

AU - Andersen, A J B

AU - Ostenfeld, A

AU - Pipper, C B

AU - Olsen, B S

AU - Hertz, A M

AU - Jørgensen, L. K.

AU - Høgsmose, J

AU - Svensson, J

N1 - This article is protected by copyright. All rights reserved.

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Aim: To evaluate current insulin pump settings in an optimally regulated paediatric population using bolus wizard. Methods: We used a retrospective study design to analyse data from 124 children on insulin pump therapy who had optimum HbA1c levels [< 59 mmol/mol (< 7.5%)] and no history of severe hypoglycaemic events. Bolus wizard settings were used to calculate the insulin to carbohydrate factors and insulin sensitivity factors. Multiple regression analysis was used to analyse the variables associated with the calculation factors. Results: Insulin to carbohydrate factor varied from 276 in the youngest group to 424 in the oldest group, and increased according to age. Insulin sensitivity factor was highest in the group aged 6 to < 12 years, with a value of 125. Age, amount of carbohydrates, number of boluses per day and insulin per kg were all significantly associated with both calculation factors. Furthermore, duration of insulin pump treatment was significantly associated with insulin sensitivity factor and percentage bolus/basal was significantly associated with insulin to carbohydrate factor. Gender, diabetes duration and BMI were not associated with any of the calculation factors. Conclusion: Optimum insulin pump settings at pump initiation depend on both insulin requirements and use of the pump. Settings need to be individualized because the standardized calculation factors are not constant for children. There is a need to develop specific age- and insulin dose-dependent calculation factors.

AB - Aim: To evaluate current insulin pump settings in an optimally regulated paediatric population using bolus wizard. Methods: We used a retrospective study design to analyse data from 124 children on insulin pump therapy who had optimum HbA1c levels [< 59 mmol/mol (< 7.5%)] and no history of severe hypoglycaemic events. Bolus wizard settings were used to calculate the insulin to carbohydrate factors and insulin sensitivity factors. Multiple regression analysis was used to analyse the variables associated with the calculation factors. Results: Insulin to carbohydrate factor varied from 276 in the youngest group to 424 in the oldest group, and increased according to age. Insulin sensitivity factor was highest in the group aged 6 to < 12 years, with a value of 125. Age, amount of carbohydrates, number of boluses per day and insulin per kg were all significantly associated with both calculation factors. Furthermore, duration of insulin pump treatment was significantly associated with insulin sensitivity factor and percentage bolus/basal was significantly associated with insulin to carbohydrate factor. Gender, diabetes duration and BMI were not associated with any of the calculation factors. Conclusion: Optimum insulin pump settings at pump initiation depend on both insulin requirements and use of the pump. Settings need to be individualized because the standardized calculation factors are not constant for children. There is a need to develop specific age- and insulin dose-dependent calculation factors.

U2 - 10.1111/dme.13064

DO - 10.1111/dme.13064

M3 - Journal article

C2 - 26773826

SN - 0742-3071

VL - 33

SP - 1360

EP - 1365

JO - Diabetic Medicine

JF - Diabetic Medicine

ER -