Benefits of an insulin dosage calculation device for adolescents with type 1 diabetes mellitus

Nicole Glaser, Sultanna B. Iden, Dayna Green-Burgeson, Claire Bennett, Karen Hood-Johnson, Dennis M Styne, Beth Goodlin-Jones

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Objective: Multiple daily injection insulin regimens (MDI) and continuous subcutaneous insulin infusion (CSII) allow adolescents with type 1 diabetes mellitus (DM) meal flexibility, and may improve metabolic control. The insulin dosage calculations, however, involve ratios of insulin to carbohydrate and corrections for high blood glucose values, and are labor-intensive and prone to error. We evaluated the impact of an insulin dosage calculation device (IDC) on metabolic control, treatment satisfaction, regimen adherence and quality of life in adolescents using MDI or CSII. Research Design and Methods: We conducted a randomized control trial using the IDC in 83 adolescents on MDI or CSII. At enrollment, patients received training on dosage calculation using either the IDC or conventional methods, and performed sample calculations. At enrollment, 6 months and 12 months, we recorded HbA1c and frequency of hypoglycemia, and patients completed questionnaires assessing treatment satisfaction, regimen adherence and quality of life. After 6 months, patients in the control group were also given the IDC. Results: We observed a higher frequency of errors with conventional calculations (53-67% incorrect calculations) than with the IDC (25-32% incorrect). At 6 months, there was a trend toward improved HbA1c in the IDC group overall (9.3 vs 8.9, p = 0.07) and a significant improvement in the subset (42%) who used the IDC consistently (9.7 vs 8.8, p = 0.03). There was no change in HbA1c in the control group during this interval (9.0 vs 8.9, p = 0.90). During months 6-12, when both groups were combined, there was a significant increase in HbA1c in patients using the IDC inconsistently or not at all (8.9 vs 9.4, p = 0.005), but no change in HbA1c in those using the IDC consistently (9.1 vs 8.9, p = 0.57). Treatment satisfaction, adherence and quality of life improved throughout the study in both groups. Conclusions: Errors in calculation of insulin dosage by adolescents occur frequently. Consistent use of an insulin dosage calculation device may help to improve metabolic control in adolescents using MDI or CSII.

Original languageEnglish (US)
Pages (from-to)1641-1651
Number of pages11
JournalJournal of Pediatric Endocrinology and Metabolism
Volume17
Issue number12
StatePublished - Dec 2004

Keywords

  • Adherence
  • Adolescents
  • Diabetes mellitus
  • HbA treatment satisfaction

ASJC Scopus subject areas

  • Endocrinology
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Benefits of an insulin dosage calculation device for adolescents with type 1 diabetes mellitus'. Together they form a unique fingerprint.

  • Cite this

    Glaser, N., Iden, S. B., Green-Burgeson, D., Bennett, C., Hood-Johnson, K., Styne, D. M., & Goodlin-Jones, B. (2004). Benefits of an insulin dosage calculation device for adolescents with type 1 diabetes mellitus. Journal of Pediatric Endocrinology and Metabolism, 17(12), 1641-1651.