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Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM

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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 childrennine aged 2–4, 14 aged 5–8, 26 aged 9–12, and 28 aged 13–17 years—2 years after the onset of insulindependent diabetes mellitus (IDDM). Mean weightbased 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-thecurve (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]

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Abbreviations

IDDM:

insulin-dependent diabetes mellitus

BMI:

body mass index

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Authors and Affiliations

  1. I Department of Paediatrics, Children's Hospital, University of Helsinki, Helsinki, Finland

    T. Simell, E. A. Kaprio & I. Sipilä

  2. II Department of Paediatrics, Children's Hospital, University of Helsinki, Helsinki, Finland

    T. Simell & H. K. Åkerblom

  3. Cardiorespiratory Research Unit, University of Turku, Turku, Finland

    T. Simell & J. Hakalax

  4. The Aurora City Hospital, Helsinki, Finland

    J. Mäenpää

  5. Department of Paediatrics, University of Kuopio, Kuopio, Finland

    A. Hakulinen

  6. Department of Paediatrics, University of Turku, Kiinamyllynkatu 4-8, FIN-20520, Turku, Finland

    T. Simell & O. Simell

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  1. T. Simell
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Simell, T., Mäenpää, J., Kaprio, E.A. et al. Serum insulin profiles in consecutive children 2 years after the diagnosis of IDDM. Diabetologia 38, 97–105 (1995). https://doi.org/10.1007/BF02369358

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  • DOI: https://doi.org/10.1007/BF02369358

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