ISSN:
1432-0428
Keywords:
Key words Insulin profiles
;
hypoinsulinaemia
;
diabetic children
;
C-peptide
;
glucose profiles
;
hypoglycaemia.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary We studied associations of 24-h serum insulin profiles with insulin dose, age, gender, haemoglobin A1c (HbA1c) and C-peptide values, as well as blood glucose profiles in 77 consecutive children – nine aged 2–4, 14 aged 5–8, 26 aged 9–12, and 28 aged 13–17 years – 2 years after the onset of insulin-dependent diabetes mellitus (IDDM). Mean weight-based insulin doses in the four age groups were similar (0.7 ± 0.2 U · kg−1· day−1 in all); body surface-area-based doses differed. Insulin doses correlated significantly with the 24-h mean and area-under-the-curve (AUC) values, and with mean values at 03.00 hours of serum insulin in the children aged 5–8 and 13–17 years. The mean insulin concentrations of the age groups (95 % confidence intervals) increased with age [6.1 (3.8, 9.7), 7.6 (5.9, 9.8), 10.4 (8.6, 12.4), and 14.0 (11.6, 16.8) mU/l; p 〈 0.0002]. The 24-h mean of serum insulin together with HbA1c concentration predicted 32 % of the variation of mean blood glucose concentrations. Of children aged less than 9 years, 50 % had insulin values less than 5 mU/l (healthy subjects' lower reference limit), and 14 % were of less than 2 mU/l (detection limit of the assay) at 03.00 hours. At 07.00 hours, 82 % had insulin values of less than 5 mU/l, and 36 % were of less than 2 mU/l, respectively. Some young children had night-time hypoglycaemia with simultaneous hypoinsulinaemia. Insulin profiles correlated poorly with the HbA1c and peak C-peptide values. We conclude that in children the mean and AUC values of serum insulin profiles are age-dependent but C-peptide independent 2 years after the diagnosis of IDDM despite similar weight-based mean insulin doses. Nocturnal and morning hypoinsulinaemia was a frequent finding in the younger children, as was biochemical hypoglycaemia. These findings suggest that insulin kinetics and sensitivity differ markedly in children according to age. [Diabetologia (1995) 38: 97–105]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001250050258
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