Abstract
The prevention of early morning hyperglycaemia remains a challenge to conventional subcutaneous insulin regimens based on two injections. We have studied the effect of delaying evening insulin administration. 16 children (age 3-12 y) participated in a 12 month cross-over study comparing bedtime (BT) with evening meal (EM) injections. Results from the first 9 patients to complete the trial (all 16 will be presented) show consistent differences in home blood sugar profiles but no overall change in HbA1. The BT injection resulted in higher blood sugars at bedtime (p<0.001), midnight (p<0.01) but lower levels pre-breakfast (NS), midday (NS) and evening meal (p<0.05). Hypoglycaemic episodes were commoner but the majority of parents preferred the convenience of BT injections. The four children whose HbA1 levels were lower on the BT injections were younger (p<0.01) and went to bed earlier (p<0.05), indicating that delayed injection may have a place in children under 7 years of age.
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Hinde, F., Johnston, D. Bedtime insulin injections in the diabetic child. Pediatr Res 18, 1220 (1984). https://doi.org/10.1203/00006450-198411000-00114
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DOI: https://doi.org/10.1203/00006450-198411000-00114