Which insulin injection regimens are used in the treatment of pediatric type 1 diabetes mellitus (DM)?

Updated: Jul 03, 2019
  • Author: William H Lamb, MD, MBBS, FRCP(Edin), FRCP, FRCPCH; Chief Editor: Sasigarn A Bowden, MD  more...
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Answer

With so many various insulins and mixtures available, a wide range of possible injection regimens exist. These can be broadly categorized into 4 types, as follows:

  • Twice-daily combinations of short- and intermediate-acting insulin.

  • Multiple injection regimens using once-daily or twice-daily injections of long-acting or intermediate-acting insulin and short-acting insulins given at each meal

  • A combination of the above 2 regimens, with a morning injection of mixed insulin, an afternoon premeal injection of short-acting insulin and an evening injection of intermediate- or long-acting insulin

  • Continuous subcutaneous insulin infusion (CSII) using an insulin pump

Although controlled clinical trials suggest improved short-term metabolic control in children using multiple injections or CSII, [72] international comparisons do not support any particular insulin regimen, [73, 74] and all have their advantages and disadvantages.

A wide variety of insulin-injection devices are available, including a simple syringe and needle, semiautomatic pen injector devices, and needle-free jet injectors. Increasing numbers of young people use insulin pumps to deliver continuous subcutaneous insulin, with bolus doses at meal times.


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