How to Safely Use Diluted Insulin in an Automated Insulin Delivery System in Very Young Children: An Educator Perspective.

Abstract

Managing type 1 diabetes in infants and very young children poses unique challenges due to their low insulin requirements, high insulin sensitivity, and rapidly changing metabolic needs. Standard insulin formulations (U100) may prove inadequate for this age group, especially when utilizing continuous subcutaneous insulin infusion or automated insulin delivery (AID) systems.This article presents our clinical experience with diluted insulin (U10) in very young children using the AID system CamAPS FX, along with a literature review, highlighting its potential benefits, such as reduced incidence of hypoglycemia and rates of technical malfunctions. We also discuss key practical considerations for implementing insulin dilution in clinical practice, including the establishment of safety protocols, caregivers and healthcare professionals training, and the importance of accurate preparation and labeling of diluted formulations to mitigate potential serious dosing errors.