Pecentage of dose given as Basal insulin in bolus basal regimen in children is ?
Question Category:
Correct Answer:
25-50%
Description:
A basal-bolus injection regimen involves taking a number of injections through the day. A basal-bolus regimen, which includes an injection at each meal, attempts to roughly emulate how a non-diabetic person&;s body delivers insulin. Intensive therapy includes the administration of insulin 3 times daily by multiple daily injections (MDI) or pen, or an external pump. Every dose of insulin is adjusted according to the pre-meal blood glucose performed at least four times daily, dietary intake, and anticipated exercise. It does not refer to the type of insulin. Total daily dose is divided as follows: * Basal dose: 25-30% of the total dose in toddlers and 40-50% in older children, given at bedtime. This suppresses the glucose production between meals and overnight. * Bolus doses: Remaining dose is divided into 3 pre-meal doses. The meal time (prandial) doses limit post-prandial hyperglycemia. Every bolus dose of insulin is adjusted as per the scale in Table I. Intensive therapy includes the administration of insulin 3 times daily by multiple daily injections (MDI) or pen, or an external pump. Every dose of insulin is adjusted according to the pre-meal blood glucose performed at least four times daily, dietary intake, and anticipated exercise. It does not refer to the type of insulin .Total daily dose is divided as follows: * Basal dose: 25-30% of the total dose in toddlers and 40-50% in older children, given at bedtime. This suppresses the glucose production between meals and overnight. * Bolus doses: Remaining dose is divided into 3 pre-meal doses. The meal time (prandial) doses limit post-prandial hyperglycemia. Every bolus dose of insulin is adjusted as per the scale in Table I. TABLE I Subcutaneous Basal-Bolus Insulin Dosing and Glycemic Targets Age group (years) Target pre-meal blood sugar* Target HbA 1c (mg%) Dose** (U/kg/d) 0-6 100-180 7.5-8.5%+ 0.6-0.7 6-12 90-180 <8% 0.7-1.0 13-19 80-130 <7.5% 1.0-1.2 Reference: GHAI Essential pediatrics, 8th edition
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