Abstract
We aimed to compare children started on twice daily injections (BD) versus multiple daily injections (MDI) from diagnosis, using HbA~1c~ and weight gain as outcome measures.
In our unit, newly diagnosed children were started on BD insulin until 2005 when we changed to MDI. Those on BD were offered a change‐over to MDI. We collected data on HbA~1c~ and body mass index standard deviation score (BMI SDS) between 2003 and 2009 at diagnosis of type 1 diabetes and those who changed from BD to MDI and after 12 months.
Eighty‐eight (45 female) children were started on BD insulin (group 1), 29 (10 female) were started on MDI (group 2), and 36 (20 female) children were started on BD and then changed to MDI (group 3). The mean HbA~1c~ at baseline and 12 months was: group 1 – 11.4%, 9.1% (p<0.001); group 2 – 11.5%, 7.9% (p<0.001); and group 3 – 8.9%, 9.2% (p=NS). The mean improvement at 12 months in HbA~1c~ was better in group 2 compared to group 1 (3.6% vs 2.3% [p<0.001]). Mean BMI SDSs at baseline and 12 months were: group 1 – 0.41, 0.90 (p<0.001); group 2 – 0.28, 0.56 (p=0.04); and group 3 – 0.8, 0.8 (p=NS). The difference in BMI SDS at 12 months between group 1 and group 2 (0.34) was not statistically significant.
It was concluded that MDI from diagnosis results in better glycaemic control and a trend towards less weight gain at 12 months than BD. Children who start on BD and then switch to MDI after 12 months do not show the same benefit. Copyright © 2011 John Wiley & Sons.