ABSTRACT
AIMS: Identifying age-dependent basal rates in type 1 diabetic children treated with continuous subcutaneous insulin infusion (CSII). METHODS: CSII-treated children with type 1 diabetes exhibiting insulin requirement > 0.5 U/kg and glycated haemoglobin (HbA1c) < 8%. The study population was composed of 198 Caucasian children (111 girls) with mean age of 9.8 +/- 3.8 years, mean duration of diabetes of 4.3 +/- 3.1 years and mean HbA1c value of 6.7 +/- 0.7%. Data were evaluated for four age groups (0-6; 6-9; 9-12, 12-18 years). Basal rates records were downloaded from pump memory. HbA1c, weight, height were measured at scheduled visits. RESULTS: Significant differences in the average hourly basal rate between groups were observed: I gr. 0.14 versus II gr. 0.24 versus III gr. 0.39 versus IV gr. 0.72 units/h; p < 0.0001. The average hourly basal rate correlated with age, body weight, BMI, diabetes duration and total insulin daily dose. Insulin peaks were observed for: I gr. - before midnight, II gr. - before midnight and in the early morning, gr. III and IV - in the early morning. CONCLUSION: Basal insulin infusion rate profiles in well-controlled paediatric patients on CSII reflect the age-dependent amount of basal insulin (20-40%) and affect circadian distribution of insulin needs.
Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/administration & dosage , Insulin Infusion Systems , Insulin/administration & dosage , Adolescent , Age Factors , Child , Child, Preschool , Female , Humans , Infant , Male , Reference ValuesABSTRACT
Both diabetes mellitus and hypertension are major risk factors for cardiovascular, renal and atherosclerotic vascular disease. Hypertension is known to be more common in patients with diabetes than in the general population. Patients with diabetes mellitus are at high risk for renal injury, which may be exacerbated by abnormalities in circadian blood pressure pattern. Ambulatory blood pressure monitoring (ABPM) permits the observation of blood pressure throughout day and night in a non-medical environment, and to quantify the circadian blood pressure variability. Recent studies with the use of ambulatory blood pressure monitoring have shown that the physiological nocturnal fall in blood pressure is blunted or absent in some individuals with type 1 diabetes who are completely normotensive by conventional criteria. Patients with type 1 diabetes and microalbuminuria have higher nocturnal blood pressure than either patients with type 1 diabetes and normal albumin excretion or age-matched controls. Moreover, changes in the circadian pattern of blood pressure in patients with type 1 diabetes may predict the development of albuminuria.
Subject(s)
Blood Pressure Monitoring, Ambulatory , Blood Pressure , Circadian Rhythm , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/physiopathology , Hypertension/complications , Hypertension/physiopathology , Albuminuria/etiology , Clinical Trials as Topic , Diabetes Mellitus, Type 1/urine , Humans , Hypertension/urineABSTRACT
Serologic tests for the detection of Salmonella serotype Enteritidis in children may become supplementary to stool culture examination. A total of 190 children were examined with a new 1-step, 2-minute test (TUBEX) that detects anti-Salmonella immunoglobulin M antibodies, which was found to be 92.6% sensitive and 94.8% specific (P<.0001).
