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. 2022 Feb;13(2):292-298.
doi: 10.1111/jdi.13547. Epub 2021 May 3.

Basal insulin requirement in patients with type 1 diabetes depends on the age and body mass index

Yukari Mitsui  1 , Akio Kuroda  2 , Masashi Ishizu  2 , Hiroyasu Mori  2 , Kiyoe Kurahashi  1 , Takeshi Kondo  3 , Sumiko Yoshida  1 , Yuko Akehi  2 , Ken-Ichi Aihara  4 , Itsuro Endo  5 , Masahiro Abe  1 , Munehide Matsuhisa  2
Affiliations

Basal insulin requirement in patients with type 1 diabetes depends on the age and body mass index

Yukari Mitsui et al. J Diabetes Investig. 2022 Feb.

Abstract

Aims/introduction: To investigate the basal insulin requirement in patients with type 1 diabetes who are on multiple daily injections (MDI) and to assess the patient characteristics that affect the percent of total daily basal insulin dose to the total daily insulin dose (%TBD/TDD).

Materials and methods: The subjects of this study were 67 inpatients with type 1 diabetes who were served diabetic meals of 25-30 kcal/kg standard body weight during several weeks of hospitalization. The basal insulin requirement was adjusted to keep the blood glucose level from bedtime to before breakfast within a 30 mg/dL difference. The bolus insulin dose before the meal was adjusted to keep the blood glucose level below 140 and 200 mg/dL before and 2 h after each meal, respectively. The total daily insulin dose (TDD), the percent of total daily basal insulin dose (TBD) to TDD (%TBD/TDD), and clinical characteristics were collected.

Results: The median (Q1, Q3) of TDD was 33.0 (26.0, 49.0) units, and the %TBD/TDD was 24.1 ± 9.8%. The %TBD/TDD was positively correlated with the body mass index (BMI) and negatively correlated with the age at the onset and at the examination according to a univariate analysis. However, the %TBD/TDD was dependent on the BMI (β = 0.340, P = 0.004) and the age at examination (β = -0.288, P = 0.012) according to the multiple regression analysis.

Conclusions: The average %TBD/TDD in patients with type 1 diabetes on MDI was approximately 24% under inpatient conditions. The basal insulin requirement was dependent on the BMI and the age at examination.

Keywords: Basal insulin; Multiple daily insulin therapy; Type 1 diabetes.

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Conflict of interest statement

AK is a member of the Speakers Bureau for Sanofi, Novo Nordisk Inc., and Eli Lilly Japan K.K. MM receives research support from Novo Nordisk Inc., and is a member of the Speakers Bureau for Sanofi, Novo Nordisk Inc., and Eli Lilly Japan K.K. The other authors do not have any potential conflicts of interest relevant to this article.

Figures

Figure 1
Figure 1
Daily variation in blood glucose levels. Seven‐point blood glucose profile during the final 3 days of hospitalization in type 1 diabetes patients: B0, before breakfast; B2, 2 h after breakfast; L0, before lunch; L2, 2 h after lunch; S0, before supper; S2, 2 h after supper; BS, before sleep. Data are shown as the mean ± SD.
Figure 2
Figure 2
TDD, TBD, and total bolus insulin. TBD, total daily basal insulin dose; TDD, total daily insulin dose; total bolus, total daily bolus insulin dose.
Figure 3
Figure 3
The %TBD/TDD. Closed circles indicate patient data. TBD, total daily basal insulin dose; TDD, total daily insulin dose.
See this image and copyright information in PMC

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