Intensive diabetes management and goal setting are key aspects of improving metabolic control in children and young people with type 1 diabetes mellitus

Table 1 Review of studies comparing different insulin regimens

Ref.	Method/population	Outcome
de Beaufort et al[10]	Observational cross-sectional international study/2036 patients(11-18 yr)	No improvement in glycaemic control over a decade Those on twice daily free mix had significantly better control and the ones on twice daily injections had the worst HbA1c
Holl et al[11]	Multicentre Observational study/872 patients (11-18 yr)	Deterioration in metabolic control in all three groups over 3 yr period One group had moved from twice daily to multiple injections
Haller et al[12]	Observational Study (enrolled patients were on preferred regimes from 12 paediatric endocrinologists)/229 patients (9-15 yr)	Increased number of insulin types correlated with increased HbA1c
Nordly et al[13]	Multicentre cross sectional sudy/874 (< 16 yr)	Children with 2 injections a day had significantly better control than children on 3 or four injections a day
Paris et al[14]	Multicentre cross-sectional study/2743 patients (< 20 yr)	Insulin pump users had better control. No difference between MDI or 2-3 injections a day
Jakisch et al[15]	Multicentre matched pair cohort analysis, comparing CSII to MDI/434 matched pairs	Significantly better HbA1c in CSII group after 1 yr but subsequently no difference at 3 yr

MDI: Multiple daily insulin; CSII: Continuous subcutaneous insulin infusion; HbA1c: Hemoglobin A1c.