Evidence map›Paper›PMID 42443623›Full record

ArticleDiabetes, obesity & metabolism2026

Comparison of Diluted Insulin (U10) Versus Standard (U100) Insulin in Automated Insulin Delivery Systems: Reducing Time Below Range in Young Children.

Heidi Falk, Ada Aaltio, Mari-Anne Pulkkinen, Tero Varimo, Anna-Kaisa Tuomaala

Abstract readComparative Study
In one paragraph

Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Heidi FalkDepartment of Pediatrics and Adolescence, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.ORCID 0009-0009-6269-5964
Ada AaltioDepartment of Pediatrics and Adolescence, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.
Mari-Anne PulkkinenDepartment of Pediatrics and Adolescence, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.ORCID 0000-0003-2836-1046
Tero VarimoDepartment of Pediatrics and Adolescence, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.
Anna-Kaisa TuomaalaDepartment of Pediatrics and Adolescence, University of Helsinki and Helsinki University Hospital, Helsinki, Uusimaa, Finland.ORCID 0000-0001-8081-188X

Funding

Lastentautien Tutkimussäätiö
6 · The paper itself

Abstract

backgroundTreating young children with Type 1 diabetes (CwT1D) is challenging due to their very small need for insulin. We investigated the safety of diluted insulin (U10) in the AID system and how its use affected glycaemic outcomes compared to standard insulin.

methodsPatients aged 0-4 years who initiated treatment with diluted insulin in an AID system during the years 2020-2025 were identified from the diabetes registry (N = 19). They had a maximum daily insulin dose of ≤ 6 units. An age and gender-matched control group (N = 27) using standard insulin (U100) in an AID system was determined. Longitudinal CGM outcomes were analysed within the treatment group from the start of diluted insulin and between groups from diagnosis over 12 months to assess time-by-treatment effects.

resultsAfter 3 months of diluted insulin use, TBR < 3.9 and TBR < 3.0 decreased significantly (from 4.6% ± 4.1% to 2.7% ± 2.5%, p = 0.008; from 1.2% ± 1.8% to 0.4% ± 0.6%, p = 0.01, respectively) and remained low through 12 months. Compared with controls, children using diluted insulin had lower TBR < 3.9 mmol/L at later follow-up visits. In the HbA1c-adjusted mixed-effects model, the between-group difference in change from 3 months was -1.85 percentage points at 9 months (95% CI: -3.26 to -0.44, p = 0.010) and -1.52 percentage points at 12 months (95% CI: -2.92 to -0.13, p = 0.032). No significant between-group changes in other CGM measures over time were observed.

conclusionThe use of diluted insulin in young CwT1D, who require low insulin doses and use an automated insulin delivery system, reduces time below range with no evidence of increased hyperglycaemia.

Indexed as

Diabetes Mellitus, Type 1Hypoglycemic AgentsInsulinInsulin Infusion SystemsBlood GlucoseChild, PreschoolContinuous Glucose MonitoringFemaleGlycated HemoglobinHumansHypoglycemiaInfantInfant, NewbornMaleRegistriesTreatment OutcomeBlood GlucoseGlycated HemoglobinHypoglycemic AgentsInsulinAID settingsAID systemchildren with Type 1 diabetesdiluted insulin

Identifiers

PMID42443623
PMCPMC13538762

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.