Real-World Total Daily Insulin Dose in over 14,000 Young Individuals with Type 1 Diabetes in the United States
Authors' conclusion
Dynamic insulin requirements across age, sex, BMI, HbA1c, and insulin delivery methods, along with difficulty in achieving glycemic targets, highlight the need for frequent reassessment of TDD, especially during puberty.
Study context
- Population
- People with T1D aged 2–25 years; mean (SD) age 16.2 (4.3) years, 48% female, 74.6% White, 80% using CGM; mean HbA1c 8.4%, 80.2% with HbA1c ≥7%
- Participants
- 14,358 people
- Outcome
- TDD (IU/kg/day), stratified by age, sex, BMI, HbA1c and insulin delivery method
Methodological detailselectronic health records, T1D Exchange Quality Improvement Collaborative
- Electronic health records
- T1D Exchange Quality Improvement Collaborative
Main finding
As reported in the abstract
TDD
- TDD increased from age 2-13 years, steepest increase from 9-13 years
- Peak TDD at age 12 years in females vs age 14 years in males
- Higher TDD in higher body mass index (BMI) and HbA1c categories
- Higher TDD in multiple daily injections (MDI) users vs insulin pump (non-HCL) and HCL users
Observational data: associations, not effects.
Original publication
Real-World Total Daily Insulin Dose in over 14,000 Young Individuals with Type 1 Diabetes in the United States. Diabetes Technol Ther. Published 12 May 2026. doi:10.
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