Insulin for Toddlers With Difficult Diabetes
- Rajiv Goonetilleke, MRCPCH,
- Melanie Pollitzer, MRCPCH and
- Nick Mann, MD, FRCPCH
- From the Royal Berkshire Hospital, Reading, U.K.
- Address correspondence and reprint requests to Dr. Rajiv Goonetilleke, Royal Berkshire Hospital, Reading RG1 5AN, U.K. E-mail: rajivgoonetilleke{at}hotmail.com
Effective control of blood glucose in toddlers with diabetes can be difficult for a variety of reasons. Unpredictable eating patterns with changes in the timing of meals and quantities eaten, as well as different levels of activity, are the major factors that impact on blood glucose levels at this age.
The Diabetes Control and Complications Trial showed the importance of good glycemic control in reducing complications of diabetes (1). Twice-daily insulin regimens with an intermediate-acting insulin such as isophane often result in unacceptable hypoglycemia in young children. We wish to describe two patients <3 years of age treated with a premeal short-acting analog insulin in conjunction with glargine insulin …
