Author(s): Musleh Jabbari, Bassam Bin-Abbas, Abdullah Al-Fares
Five Saudi children with type 1 diabetes mellitus were selected and started on determir-based basal-bolus insulin therapy. Selection criteria included diabetic children with poor diabetic control and recurrent daytime and nocturnal hypoglycemic episodes. The patients were on conventional insulin therapy that included two injections of insulin per day before shifting them to detemir-based basal bolus insulin regimen. They had type 1 diabetes mellitus for a mean duration of 3 years and were followed on basal-bolus insulin regimen therapy using detemir insulin for a mean duration of 3.5 months. Post basal-bolus regimen, there was no significant change in HbA1c level, however, there was significant reduction in frequency of hypoglycemic episodes. The frequency of hypoglycemic episodes (defined as a blood glucose level of 40 mg/dl or less) ranged from 4 to 9 episodes per month on conventional insulin therapy and dropped to 2-5 per month post basal-bolus therapy. The present study showed that basal-bolus insulin regimen is effective in improving the metabolic control in type 1 diabetic Saudi children. The results of this local experiment are encouraging to implement this mode of intensive insulin therapy in all candidate diabetic Saudi children.