The Influences of Multiple Daily Insulin Regimen and Conventional Insulin Regimen on Level of HbA1C in Type 1 Diabetes in Children

Document Type : Original Article

Authors

Clinical Science Branch, College of Medicine, University of Sulaimani, Kurdistan Regional of Iraq.

10.22038/psj.2026.92975.1512

Abstract

Introduction:
Type 1 diabetes (T1DM), as a chronic endocrine disorder associated with insulin deficiency and accompanied by hyperglycemia. This study aims to compare the effect of multiple daily insulin regimen (MDI) and conventional insulin regimen (CIR) on HbA1C levels in children with T1DM in terms of glycemic control, complications, and quality of life.
Materials and Methods:
The proposed study was a retrospective cohort study conducted on 84 children aged between 2-18 years and who attended a hospital in Sulaymaniyah, Iraq, in the first half year of 2025. A structured questionnaire collected data on socio-economic status, and health history. The hospital records were used to collect the data required for the study. HbA1C levels, insulin regimen details, frequency/severity of glycemic events, incidence of complications, and adherence and quality of life scores were collected. Statistical significance was set at P<0.05.
Results:
Although children on MDI showed higher mean HbA1c levels over 12–24 months (74.3% with HbA1c > 9% vs. 63.3% in the CIR group), a larger proportion of MDI users (20% vs. 2%) reported a noticeable decrease in HbA1c after switching to this regimen. Blood glucose monitoring frequency was higher in the MDI group (P<0.001), yet hypoglycemia and hyperglycemia rates were comparable between groups (P>0.703 and P>0.061), respectively. Notably, dietary adherence was suboptimal in both cohorts, and most participants expressed uncertainty regarding regimen ease of use.
Conclusion:
The current study found that the MDI regimen compared to the CIR regimen was linked to high levels of HbA1c level among young patients with T1DM, therefore, inhibiting the expected superiority of MDI in attaining high-quality glycemic regulation.

Keywords

Main Subjects

References

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Journal of Patient Safety & Quality Improvement
Volume 14, Issue 2
April 2026
Pages 85-95

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