OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS

This study was aimed to determine peculiarities in regimens of the pump insulin therapy and to reveal the optimal basal-to-bolus insulin ratio that are necessary for achieving optimal glycemic control in adoles-cents with type 1 diabetes mellitus (T1DM).  82 adolescents at the age of 14–18 with T1DM...

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Main Authors: G. A. Galkina, A. A. Voropay, M. A. Levkovich, S. V. Vorobiov, M. V. Komkova, N. V. Morozova
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2015-10-01
Series:Бюллетень сибирской медицины
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Online Access:https://bulletin.ssmu.ru/jour/article/view/182
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author G. A. Galkina
A. A. Voropay
M. A. Levkovich
S. V. Vorobiov
M. V. Komkova
N. V. Morozova
author_facet G. A. Galkina
A. A. Voropay
M. A. Levkovich
S. V. Vorobiov
M. V. Komkova
N. V. Morozova
author_sort G. A. Galkina
collection DOAJ
description This study was aimed to determine peculiarities in regimens of the pump insulin therapy and to reveal the optimal basal-to-bolus insulin ratio that are necessary for achieving optimal glycemic control in adoles-cents with type 1 diabetes mellitus (T1DM).  82 adolescents at the age of 14–18 with T1DM, using continuous subcutaneous insulin infusion (CSII) from 5 months to 7.5 years were monitored with continuous glucose monitoring (CGM) system «Guar-dian Real Time» or CGM system, built in MiniMed Paradigm Revel System 722 (Medtronic Minimed, USA). Assessing the quality of glycaemic control was based on the level of glycated haemoglobin (HbA1c). The results of CGM were reviewed and average for 3 days performances: total daily dose of insulin, dose of basal and bolus insulin, basal-to-bolus insulin ratio, carbohydrate content of the meal, expressed in BE, carbohydrate ratio, insulin sensitivity factor were determined. The patients were subdivided into 2 groups: group 1 – adolescents with the optimal/suboptimal glycemic control (n = 55), 2 – adolescents with long-standing poorly controlled T1DM (n = 27). Average total daily dose of basal insulin (U in a day, U per kg in a day) in adolescents group 1 was significantly higher, com-pared with patients in group 2 (р = 0.043; р = 0.038 respectively). Patients in group 2 received more car-bohydrates with a meal intake and had higher doses of average total daily bolus insulin. The average ba-sal-to-bolus ratio from group 1 patients was 51/49%, compared with group 2 patients – 45/55% (р = 0.026).  An important condition for achieving optimal glycemic control is a high level of compliance and skills of adolescents. Optimal well-balanced basal-to-bolus insulin ratio in adolescents with T1DM on CSII, which can provide improvements in blood glucose management and reducing the risk of complications of the disease, is 51/49%.
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series Бюллетень сибирской медицины
spelling doaj-art-8a298b41b29645d4be232c3161b3454e2025-08-20T04:00:12ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842015-10-01145152110.20538/1682-0363-2015-5-15-21180OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUSG. A. Galkina0A. A. Voropay1M. A. Levkovich2S. V. Vorobiov3M. V. Komkova4N. V. Morozova5Rostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-Don; Rostov State Medical University, Rostov-on-DonRostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-DonRostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-DonRostov State Medical University, Rostov-on-DonRostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-DonRostov Scientific-Research Institute of Obstetrics and Pediatrics, Rostov-on-DonThis study was aimed to determine peculiarities in regimens of the pump insulin therapy and to reveal the optimal basal-to-bolus insulin ratio that are necessary for achieving optimal glycemic control in adoles-cents with type 1 diabetes mellitus (T1DM).  82 adolescents at the age of 14–18 with T1DM, using continuous subcutaneous insulin infusion (CSII) from 5 months to 7.5 years were monitored with continuous glucose monitoring (CGM) system «Guar-dian Real Time» or CGM system, built in MiniMed Paradigm Revel System 722 (Medtronic Minimed, USA). Assessing the quality of glycaemic control was based on the level of glycated haemoglobin (HbA1c). The results of CGM were reviewed and average for 3 days performances: total daily dose of insulin, dose of basal and bolus insulin, basal-to-bolus insulin ratio, carbohydrate content of the meal, expressed in BE, carbohydrate ratio, insulin sensitivity factor were determined. The patients were subdivided into 2 groups: group 1 – adolescents with the optimal/suboptimal glycemic control (n = 55), 2 – adolescents with long-standing poorly controlled T1DM (n = 27). Average total daily dose of basal insulin (U in a day, U per kg in a day) in adolescents group 1 was significantly higher, com-pared with patients in group 2 (р = 0.043; р = 0.038 respectively). Patients in group 2 received more car-bohydrates with a meal intake and had higher doses of average total daily bolus insulin. The average ba-sal-to-bolus ratio from group 1 patients was 51/49%, compared with group 2 patients – 45/55% (р = 0.026).  An important condition for achieving optimal glycemic control is a high level of compliance and skills of adolescents. Optimal well-balanced basal-to-bolus insulin ratio in adolescents with T1DM on CSII, which can provide improvements in blood glucose management and reducing the risk of complications of the disease, is 51/49%.https://bulletin.ssmu.ru/jour/article/view/182diabetes mellituscontinuous glucose monitoringoptimal basal-to-bolus insulin ratio
spellingShingle G. A. Galkina
A. A. Voropay
M. A. Levkovich
S. V. Vorobiov
M. V. Komkova
N. V. Morozova
OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
Бюллетень сибирской медицины
diabetes mellitus
continuous glucose monitoring
optimal basal-to-bolus insulin ratio
title OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
title_full OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
title_fullStr OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
title_full_unstemmed OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
title_short OPTIMAL REGIMENS OF THE BASAL-BOLUS INSULIN THERAPY IN ADOLESCENTS WITH TYPE 1 DIABETES MELLITUS
title_sort optimal regimens of the basal bolus insulin therapy in adolescents with type 1 diabetes mellitus
topic diabetes mellitus
continuous glucose monitoring
optimal basal-to-bolus insulin ratio
url https://bulletin.ssmu.ru/jour/article/view/182
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AT aavoropay optimalregimensofthebasalbolusinsulintherapyinadolescentswithtype1diabetesmellitus
AT malevkovich optimalregimensofthebasalbolusinsulintherapyinadolescentswithtype1diabetesmellitus
AT svvorobiov optimalregimensofthebasalbolusinsulintherapyinadolescentswithtype1diabetesmellitus
AT mvkomkova optimalregimensofthebasalbolusinsulintherapyinadolescentswithtype1diabetesmellitus
AT nvmorozova optimalregimensofthebasalbolusinsulintherapyinadolescentswithtype1diabetesmellitus