Age-Specific Basal Rate Profile Characteristics at Initiation of Insulin Pump Therapy

Abstract

The use of insulin pumps in the treatment of type 1 diabetes mellitus increased tremendously in the developed countries during recent years. In order to successfully switch patients previously treated with multiple daily insulin injections to insulin pump therapy, a proper distribution of total daily insulin is required. An important step is to determine the daily basal rate, and to tailor the basal rate pattern according to the 24-hourly basal insulin need. The aim of our study was to identify the age-dependent characteristics of basal rate profiles at the initiation of insulin pump therapy during hospital admission; 70 patients who met the criteria of the national program for insulin pumps were included; they were divided into 4 age-groups (Group 1: 6 to < 12 years; Group 2: 12 to < 18 years; Group 3: 18 to < 25years; Group 4: >25 years), and the daily basal rate requirement and hourly distribution of the basal rate were investigated. A significant difference between basal insulin requirements was observed among the four groups (Group 1-0.36±0.14; Group 2 -0.64±0.21; Group 3 -0.64±0.19; Group 4-0.57±0.20; p<0.001), and a bimodal distribution of basal insulin need was observed for all age-groups, but with variable age-dependent amplitudes. Identification of the optimal proportion of insulin and the 24- hourly basal insulin distribution for different age groups can help easily initiate and implement the right pattern right from the beginning of insulin pump therapy.