The short-term results of intensive insulin therapy in preadolescent children with type-1 diabetes


Ökten A., Kaya G., Kalyoncu M., Çan G.

Turkish Journal of Medical Sciences, vol.31, no.2, pp.137-142, 2001 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 31 Issue: 2
  • Publication Date: 2001
  • Journal Name: Turkish Journal of Medical Sciences
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.137-142
  • Keywords: Intensive insulin therapy, Multiple injections, Preadolescent children, Type 1 diabetes mellitus
  • Çanakkale Onsekiz Mart University Affiliated: No

Abstract

Purpose: The aim of this study was to observe the effects of and compliance with an intensive insulin regimen in preadolescent children with type-1 diabetes. Patients and methods: Eleven insulin-dependent diabetic patients, five girls and six boys aged 8-11 years (mean 9 years 3 months) with a mean±SD diabetes duration of 2±1.07 years, participated in this study. The results of the intensive insulin regimen were evaluated after one-year follow-up in 11 patients, and in 8 patients at 18 months. In the first year of this study we aimed to bring about higher blood glucose than is generally advised, in order to avoid hypoglycemia. After one year, we encouraged the patients to promote strict metabolic control. Results: Blood glucose and HbA1c levels had significantly decreased after the intensive insulin regimen at the 12th month of treatment (p<0.05 and p<0.01, respectively), and at the 18th month of treatment (p<0.01 and p<0.01, respectively). The mean body weight and mean body mass index (BMI) changes were insignificant at 12 months (p<0.05), but had significantly increased at 18 months (p<0.05 and p<0.01, respectively). None of the patients experienced symptomatic hypoglycemic episodes during the 12-month follow-up, but severe symptomatic hypoglycemic episodes were determined at an incidence of 36% between 12th and 18th months. Diastolic blood pressure decreased significantly (p<0.05). Total triglycerides, VLDL triglycerides and total cholesterol as well as LDL cholesterol (LDL-C). VLDL cholesterol (VLDL-C) and apoprotein B (apo B) decreased (p<0.05) but high-density lipoprotein cholesterol (HDL-C) and apoprotein A1 (apo A1) increased (p<0.05). The glomerular filtration rate (GFR) and microalbumin excretion rate did not change (p>0.05). Conclusion: Although the patients had no symptomatic hypoglycemic episodes in the first 12 months, they had symptomatic hypoglycemia between 12th and 18th months, when there was stricter metabolic control. We conclude that this regimen is appropriate for preadolescent children.