P-292: Early glycemic outcomes following transition from premixed to basal-BOLUS insulin regimens among Cambodian youth with type 1 diabetes: a case series
V Chea, K TouchAbstract
Introduction
In Cambodia, most children and adolescents with type 1 diabetes (T1D) are initially managed using twice-daily premixed insulin due to limitations in structured education and resource availability. Following prior qualitative work describing patient experiences during this transition, real-world data on early glycemic outcomes after switching to basal-bolus therapy remain limited.
Objectives
To evaluate early changes in glycemic control and hypoglycemia following transition from premixed to basal-bolus insulin regimens.
Methods
A case series was conducted among 13 youth with T1D (5 male), with a mean age of 19.2 years (range 12–22) and mean age at diagnosis of 16.4 years. Participants transitioned from premixed insulin to a basal-bolus regimen. HbA1c levels were collected before transition and at 3 months after. Hypoglycemia was defined as any self-reported episode within the preceding month. Outcomes were analyzed descriptively.
Results
Mean HbA1c decreased from 10.2% (range 8.9–12.6) to 8.5% (range 7.2–10.4), corresponding to a mean reduction of 1.7%. Eleven of 13 participants (84.6%) demonstrated improvement in HbA1c. The proportion reporting hypoglycemia decreased from 53.8% (7/13) to 30.8% (4/13). Among those with baseline hypoglycemia, 57.1% reported resolution at follow-up. No severe hypoglycemia was observed.
Conclusions
Transition to basal-bolus insulin was associated with improved glycemic control and reduced hypoglycemia in Cambodian youth with T1D. These findings support the feasibility and clinical benefit of basal-bolus therapy in resource-limited settings, highlighting the importance of structured education and follow-up. Access to supportive care models, including programs such as the Changing Diabetes in Children program that facilitate insulin availability, glucose monitoring, and education, may further support improved outcomes in this population.