Background The life of patients with diabetes mellitus is populated with hypo- and hyperglycaemias, both of which are associated with inherent dangers.
Existing formulas attempting to quantify patients’ insulin requirements have proved ineffective and rather arbitrary1; they are based on estimations of 24 hour consumptions of insulin and carbohydrates in the average person.
Objective This paper tests the effectiveness of the 0.12 formula that is based on patient’s weight and carbohydrates consumption. It calculates glucose and insulin sensitivity and guides the treatment of hypo- and hyperglycaemia, specifically for each patient.
Method Data from the Continuous Glucose monitoring system (CGMS) applications and the associated food diary were used to assess the blood sugar achieved after hypo- and hyperglycaemia treatment. This was compared to that expected via the 0.12 formula using the Wilcoxon statistical analysis.
Results 20 and 42 patients were assessed for hypoglycaemia and hyperglycaemia respectively.
In either treatment, there was no statistically significant difference between expected and achieved blood sugar; p-values were 0.53 and 0.072 respectively.
Furthermore, insulin sensitivity derived using the 0.12 formula was compared to that calculated through the historically popular 100 rule1. Wilcoxon statistical analysis showed significant statistical difference between the two formulas; p-value 0.0025, (confidence interval +/- 0.000484).
Conclusion This data demonstrates that the proposed formula is safe, reliable and effective for the management of hypo- and hyperglycaemia in children with type I diabetes mellitus and should be implemented widely to improve safe practise. As it is patient specific and user-friendly, it allows patients/parents to feel in control over their diabetes and contributes to overall patient safety.
Hanas, R. Type 1 Diabetes in Children, adolescents and young adults. Class Publishing, London 2007.