Title: CROSS SECTIONAL, REAL WORLD INSULIN REGIMEN SETTINGS IN CHILDREN WITH T1D, EXPERIENCE FROM TIDEPOOL’S LARGE DATA REPOSITORY. In most children with Type 1 Diabetes (T1D) intensive insulin therapy includes customized basal insulin settings which vary across different times of the day, and bolus dosing for meals and blood glucose (BG) levels that are above target. Bolus amounts are calculated based on equations referred to as insulin to carbohydrate ratio (ICR) and insulin sensitivity factor (ISF). To set these equations, most endocrinologists use a few common equations to derive their patients' initial total daily doses (TDD), the portion to be given as basal insulin, the ICR and the ISF. These settings are continuously adjusted as children grow and develop with changes in their weight and hormonal milieu. To provide guidance on what insulin regimens are expected to look like, we examined the distributions of several parameters in insulin dosing in children (age 1-18 years) who have had T1D for >1 year, and are managed by insulin pumps and continuous glucose monitoring (CGM), and who uploaded their data to the Tidepool Big Data Donation Project. For this study, patients who met the entry criteria were divided into age buckets of 1-5, 6-8, 9-12, 13-17, and 18-24 years. Data were extracted from the Tidepool platform anonymously, and were included for analysis if patients had at least 30 days of pump and CGM data. We report on several parameters across the age groups, including TDD, total basal insulin and basal to bolus ratios, ICR, ISF, total daily carbohydrates, percent of CGM readings in target range (70-180mg/dL), and below 70mg/dL.
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