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[IP] Parents of new pumpers, in case you haven't read this



PUBERTAL STATUS INFLUENCES INSULIN PUMP DOSING IN DIABETIC CHILDREN
In children  with type I diabetes, pubertal status influences the total
daily insulin dose needed when converting from multiple daily injections
to continuous subcutaneous insulin infusion (CSII), according to a
recent report.
Reuters Health Information  2002
http://www.medscape.com/viewarticle/430291?srcmp=endo-032202
<a href="http://www.medscape.com/viewarticle/430291?srcmp=endo-032202">
Read it Here</a>
Pubertal Status Influences Insulin Pump Dosing in Diabetic Childre
NEW YORK (Reuters Health) Mar 19 - In children with type I diabetes,
pubertal status influences the total daily insulin dose needed when
converting from multiple daily injections to continuous subcutaneous insulin
infusion (CSII), according to a recent report.
CSII is an increasingly popular method of achieving improved metabolic
control in children and adolescents with diabetes. However, it was unclear
whether these patients could be converted to CSII in the same way as adults.
Dr. Stephen E. Gitelman and colleagues, from the University of California at
San Francisco, evaluated CSII dosing in 65 diabetic children who had
previously received multiple daily insulin injections for metabolic control.
The authors' findings are published in the of February issue of The Journal
of Pediatrics.
The researchers found that pubertal patients required an 18% reduction in
their total daily insulin dose to achieve optimal control. Prepubertal
patients, in contrast, required minimal change in their total daily insulin
dose.
In both patient groups, optimal control was achieved when the basal insulin
dose comprised 40% to 45% of the total insulin dose. In prepubertal
patients, the maximal basal rate appeared to occur in the late evening hours
as opposed to the dawn phenomenon typically described in adolescents and
adults.
"In adults, it is recommended that the total insulin dose may be decreased
by 25%, with 50% of that, or 0.22 U/kg/day used as basal insulin," the
authors state. The current findings indicate that these CSII dosing
guidelines do not necessarily apply to children.
"Prospective studies are certainly needed to evaluate not only insulin
dosing, but also efficacy and quality-of-life issues," Dr. Gitelman's team
concludes.
J Pediatr 2002;140:235-240.
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