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Nighttime insulin requirements greater for young children vs. teens, adults
Children with type 1 diabetes have a greater range of insulin requirements, particularly at night, compared with adolescents and adults with the condition, according to a study of hybrid closed-loop insulin delivery system users.
“[This research] helps to understand the challenges parents/guardians have to cope with when managing diabetes of their young offspring,” Roman Hovorka, PhD, MSc, a professor of metabolic technology and the director of research in the department of pediatrics at the University of Cambridge, United Kingdom, told Endocrine Today. “The research will also inform reimbursement of closed-loop systems in this particular population. “
Hovorka and colleagues conducted a retrospective analysis of data from 20 children aged 6 years or younger with type 1 diabetes (mean age, 4.6 years; 55% girls), 21 children aged 7 to 12 years with type 1 diabetes (mean age, 10.7 years; 66.7% girls), 15 children aged 13 to 17 years with type 1 diabetes (mean age, 15.3 years; 53.3% girls) and 58 adults with type 1 diabetes (mean age, 37.8 years; 48.3% women) who took part in trials assessing hybrid closed-loop insulin delivery systems. Participants were recruited from Austria, Germany, Luxembourg, the United Kingdom and the United States. Using the data, the researchers calculated the coefficient of variation for insulin delivery.
According to the researchers, compared with children aged 13 to 17 years, insulin delivery requirements varied by 10.2 percentage points more for children aged 12 years or younger at night (P = .049) and by 6.4 percentage points more during the day (P = .014). When compared with insulin delivery variance for adults, the measures for children aged 12 years or younger were 10.7 percentage points higher during the night (P = .003) and 6.4 percentage points higher during the day (P = .002).
“The premise was that young children have highly variable insulin needs during the day due to unpredictable eating patterns and physical activity, but that this also applies to night was a particular surprise,” Hovorka said. “Young children should have a priority access to diabetes technology.” – by Phil Neuffer
For more information:
Roman Hovorka, PhD, MSc, can be reached at rh347@cam.ac.uk.
Disclosures: Hovorka reports that he has received speaker honoraria from Eli Lilly and Novo Nordisk, served on advisory panels for Eli Lilly and Novo Nordisk, received license fees from B. Braun and Medtronic, served as a consultant to B. Braun and has patents and patent applications related to closed-loop. Please see the study for all other authors’ relevant financial disclosures.