Comparative study between multiple daily injections and conventional insulin regimens in Iraqi children and adolescents with type 1 diabetes mellitus

Abstract

Background: Type 1 diabetes mellitus is the most common endocrine-metabolic disorder of childhood and adolescence. The discoveryof insulin in 1922 make a major breakthrough in therapy of diabetes. There are two known insulin regimens, conventional and the basal bolus regimens. While conventional insulin regimen still used in some areas, it is not the preferred regimen. Management is best accomplished by a multidisciplinary team consisting of child, family, physicians, nurse educators, dietitians, and mental health professionals.Objectives: To assess the effect iof basal bolus regimen on the glycemic control, risk of hypoglycemia and ketoacidosis in comparison with conventional therapy in Iraqi children and adolescents with type 1 diabetes mellitus.Patients and method: A comparative study had been conducted at the pediatrics clinic of the National Diabetic Center, Al-Mustansiriya University during the period from February 2017 to November 2017. Seventy-two patients with type 1 diabetes had been included, of which 40 on conventional regimen and 32 on basal bolus regimen (multiple daily injections). Patients were assessed by HbA1c, hypoglycemic and ketoacidosis episodes.Results: The basal bolus regimen group had more diabetic ketoacidosis (P= 0.035) in comparison to conventional group but didn’t differ in occurrence of hypoglycemic episodes (P= 0.673) and HbA1c (P=0.2).Conclusions: In Iraqi children and adolescents with type 1 diabetes, in comparison with conventional regimen, there was no more hypoglycemic episodes in basal bolus regimen with nearly similar glycemic control as indicated by HbA1c, but it was associated with more diabetic ketoacidosis in the absence of full diabetes team and tools that improve patients' compliance.