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Timing of mealtime insulin can affect quality of life

EASD 2020
Bolus insulin dosing still poses challenges to most people with type 1 diabetes (T1D). A majority of patients would prefer to administer insulin immediately prior to or following a meal; this timing is thought to improve their quality of life.

 A multinational study assessed attitudes, behaviours, and the overall impact of pre-meal (15-20 minutes) bolus insulin dosing on adults with T1D (n=1,401), parents of children with T1D (n=350), and physicians (n=960) [1]. Of the adults with T1D, 46% were male with a mean age of 43 years and a mean duration of T1D of 19 years. Most (72%) administered their bolus insulin by injection, and 28% used an insulin pump. Continuous glucose monitoring was used by 43%. The mean age of the children was 10 years with a mean T1D duration of 4 years, 64% was male. Of the children, 74% administered their bolus insulin by injection and 26% used an insulin pump, with 58% using continuous glucose monitoring. A vast majority (96%) of both adults with T1D and parents of children with T1D understood the importance of administering bolus insulin accurately, but only 35% of adults and 47% of parents felt very confident in accurately estimating the amount of insulin required, and 91% of adults and 96% of parents experienced difficulties with pre-meal insulin dosing. Almost all physicians (99.6%) reported that they believed their patients with T1D found pre-meal bolus insulin dosing challenging. Both T1D adults (82%) and parents (93%) felt that administering insulin 15-20 minutes before a meal had a negative impact on quality of life, while 73% of adults and 67% of parents preferred bolus insulin administration either immediately before (42% adults, 44% parents) or after (31% adults, 23% parents) a meal.

  1. Lane W, et al. The burden of mealtime insulin dosing in adults and children with type 1 diabetes. EASD 2020. Abstract #694.

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