Basal-bolus regimen versus twice-daily premixed insulin in the treatment of childhood type 1 diabetes mellitus in Mosul City: A comparison study

BACKGROUND: Type 1 diabetes mellitus is the most common endocrine-metabolic disorder in childhood and adolescence. Some families may find it difficult to administer four daily injections, especially in young children, or to use the newer, expensive insulin analogs and pumps. For this reason, many physicians are still using the classical two-injection schedule, using premixed insulin in certain areas of the world.

AIM: To assess glycemic control and complication indicators in type 1 diabetic children on premixed or basal-bolus insulin.

METHODS: One hundred children aged 2–14 years with type 1 diabetes mellitus were studied at multiple diabetes care centers; fifty were receiving premixed insulin, and the other fifty were on a basal-bolus insulin regimen. Evaluations were made based on HbA_1c levels, occurrences of hypoglycemia, ketoacidosis, and other complications.

RESULTS: The study revealed significant improvements in HbA_1c levels in the basal-bolus insulin group compared to premixed insulin patients three and six months after treatment (p=0.048 and p=0.005, respectively). Patients using the premixed regimen experienced more frequent hypoglycemia attacks (p=0.001) and injection site complications, such as hypertrophy (p=0.001).

CONCLUSIONS: It has been revealed that a basal-bolus regimen (MDI) improves children’s and teenagers’ glycemic control with fewer complications.

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