Twice-daily injections and multiple daily injections of insulin in toddlers with type 1 diabetes: a retrospective cohort study

Continuous subcutaneous insulin infusion is limited in practical use due to poor economic condition and less imported machine. [...]twice-daily injection of self-mixing short- and intermediate-acting insulin provides an alternative choice, which shows characteristics such as less number of injections, more accessible drugs, and multiple diets for toddlers. According to different insulin regimens, the patients were divided into two groups: group 1, in which the patients received twice-daily injections of self-mixing short and intermediate-acting insulin before breakfast and dinner; group 2, in which the patients received multiple daily injections (MDI) of rapid-acting insulin before each meal and long-acting analog once daily. According to follow-up mode in our department (follow-up visit was made every 3 months, the patients additionally returned to the hospital at one month after discharge to assess adaption to situation), follow-up records at the 1st, 3rd, 6th, 9th, and 12th month of insulin treatment were summarized. According to parametric estimated values, the decrease in HbA1c level was gradually accelerated within the first 6 months in both groups; the interaction analysis showed that the interaction effects between two groups were statistically significant at the 3rd month (P = 0.003), indicating a more obvious decreasing trend of HbA1c level in group 1 within the first 3 months, with a smaller difference in decreasing trend of HbA1c level at other time points.