Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 30 P28

BSPED2012 Poster Presentations (1) (66 abstracts)

Improvement in HbA1c following change from three times daily injections to a basal bolus insulin regimen in the Lothian paediatric diabetes population

L E Bath , K J Noyes , R T Mitchell & S Grosser


Department for Diabetes and Endocrinology, Royal Hospital for Sick Children, Edinburgh, UK.


Background: The need for improved glycaemic control in children with type 1 diabetes in Scotland is well recognised; DIABAUD 3 identified that only 9.7% achieved the national HbA1c target.

Aim: To evaluate whether a change from three times daily injection regimen to a basal bolus regimen with carbohydrate counting at diagnosis will result in an improvement in immediate and longer term glycaemic control.

Method: We included children <16 years of age admitted to Royal Hospital for Sick Children, Edinburgh with a new diagnosis of non-decompensated type 1 diabetes Mellitus. A retrospective case note review was performed for children admitted before August 2010 (n=36) started on three times daily injections and a prospective case note review for children admitted after August 2010 (n=36) started on basal bolus regimen. Data collected consisted of HbA1c and initial blood glucose and blood ketone results, as well as HbA1c values at 6 and 12 months follow up.

Results: Children on the basal bolus regimen showed better control in the last 24 h before discharge, with 37% of readings under 10 mmol/l vs 30.5% on the previous regimen. HbA1c was measured at diagnosis, 6 and 12 months. At 6 months after diagnosis mean HbA1c had decreased further in children commenced on basal bolus regimen, compared with children commenced on the standard regimen (44.7 vs 36.6%, P<0.05). This was despite the fact that 25/36 of those originally commenced on the standard regimen subsequently switched to a basal bolus during the follow up period.

Conclusion: In the Lothian population children started on a basal bolus regimen at diagnosis showed better glycaemic control during admission and at 6 months post diagnosis. Data collection is ongoing for HbA1c results at 12 months. The reasons for this improved glycaemic control may be mutifactorial and further studies are required.

Volume 30

40th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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