Percentage of dose given as basal insulin in bolus basal regimen in children is?

Correct Answer: 25 – 50%
Description: Several factors influence the initial daily insulin dose per kilogram of body weight. The dose is usually higher in pubertal children. It is higher in those who have to restore greater deficits of body glycogen, protein, and fat stores and who, therefore, have higher initial caloric capacity. On the other hand, most children with new-onset diabetes have some residual a-cell function (the "honeymoon" period), which reduces exogenous insulin needs. Residual (3-cell) function usually fades within a few months and is reflected as a steady increase in insulin requirements and wider glucose excursions. The initial insulin schedule should be directed toward the optimal degree of glucose control in an attempt to duplicate the activity of the (3-cell). Acceptable glucose control can be obtained with new insulin analogs used in a basal-bolus regimen, that is, with slow-onset, long-duration background insulin for between-meal glucose control and rapid-onset insulin at each meal. Bolus Insulin Age(yr) Target glucose(Mg/dl) Total daily insulin(U/kg/d) Basal insulin,% of total daily dose Units added per 100 mg/dl above target Units added per 15g at meal 0 - 5 100 - 200 0.6 - 0.7 25 - 30 0 - 50 0 - 50 5 - 12 80 - 150 0.7 - 1.0 40 - 50 0 - 75 0 - 75 12 - 18 80 - 150 1.0 - 1.2 40 - 50 1 - 2 1 - 2
Category: Pediatrics
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