{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T21:31:34Z","timestamp":1765402294826,"version":"3.46.0"},"reference-count":31,"publisher":"BMJ","issue":"6237","license":[{"start":{"date-parts":[[1980,8,9]],"date-time":"1980-08-09T00:00:00Z","timestamp":334627200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J"],"published-print":{"date-parts":[[1980,8,9]]},"abstract":"<jats:p>Twenty-four-hour metabolic profiles were performed twice in each of 15 diabetic children, once when they were receiving single daily injections of insulin (Monotard plus Actrapid) and once on a twice-daily regimen (Semitard plus Actrapid). Before the study control was optimised at home on each regimen. There were no differences in overall 24-hour diabetic control on the two regimens as measured by mean blood glucose concentration, area under the blood glucose curve, M value, and 24-hour urinary glucose excretion. Hyperglycaemia after breakfast occurred on both regimens. Significant differences were noted before breakfast, when blood glucose and ketone concentrations were lower and plasma free insulin higher on the single-injection regimen, and after supper and during the night, when blood glucose values were lower on the two-injection regimen and associated with a rise in plasma free insulin after the evening injection. Once-daily injections provided insufficient circulating insulin after the evening meal, while twice-daily injections did not last through the night. Plasma C peptide, indicating residual endogenous insulin secretion, was just detectable in two children but easily detectable in four children, whose 24-hour diabetic control was significantly better than that in the remaining 11 children.<\/jats:p>\n                  <jats:p>Conclusions about the superiority of one insulin regimen over another must be based on specific differences in diabetic control. Both regimens studied achieved adequate control, and though neither provided physiological control specific modifications to the regimens could help to produce more normal profiles.<\/jats:p>","DOI":"10.1136\/bmj.281.6237.414","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T18:32:30Z","timestamp":1238697150000},"page":"414-418","source":"Crossref","is-referenced-by-count":31,"title":["Twenty-four-hour metabolic profiles in diabetic children receiving insulin injections once or twice daily"],"prefix":"10.1136","volume":"281","author":[{"given":"G A","family":"Werther","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P A","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R C","family":"Turner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J D","family":"Baum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1980,8,9]]},"reference":[{"key":"ref_1","first-page":"113","volume":"43","author":"O'Leesky, S.; Shreeve, D.R.; diabetes, Sutcliffe C.H.Brittle","year":"1974","unstructured":"O'Leesky S, Shreeve DR, Sutcliffe CH. Brittle diabetes. Q J Med 1974; 43:113-25.","journal-title":"Q J Med"},{"issue":"9","key":"ref_2","first-page":"1","article-title":"Retinopathy and nephropathy in diabetes mellitus. Comparison of the effects of two forms of treatment","volume":"1960","author":"Johnsson, S.","unstructured":"Johnsson S. Retinopathy and nephropathy in diabetes mellitus. Comparison of the effects of two forms of treatment. Diabetes 1960;9:1-8.","journal-title":"Diabetes"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.2337\/diab.25.5.463","article-title":"Effect of multiple daily insulin injections on the course of diabetic retinopathy","volume":"25","author":"Job, D.; Eschwege, E.; Guyot-Argenton, C.; Aubry, J.P.; Tchobroutsky, G.","year":"1976","unstructured":"Job D, Eschwege E, Guyot-Argenton C, Aubry JP, Tchobroutsky G. Effect of multiple daily insulin injections on the course of diabetic retinopathy. Diabetes 1976;25:463-9.","journal-title":"Diabetes"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/BF00423144","article-title":"Delayed progression of diabetic retinopathy by divided insulin administration: a further follow-up","volume":"16","author":"Eschwege, E.; Job, D.; Guyot-Argenton, C.; Aubry, J.P.; Tchobroutsky, G.","year":"1979","unstructured":"Eschwege E, Job D, Guyot-Argenton C, Aubry JP, Tchobroutsky G. Delayed progression of diabetic retinopathy by divided insulin administration: a further follow-up. Diabetologia 1979;16:13-5.","journal-title":"Diabetologia"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0300-595X(77)80049-2","article-title":"Some practical aspects of the management of diabetes","volume":"6","author":"Bloom, A.","year":"1977","unstructured":"Bloom A. Some practical aspects of the management of diabetes. 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Is it desirable ?","volume":"88","author":"Drash, A.","year":"1976","unstructured":"Drash A. The control of diabetes mellitus: Is it achievable ? Is it desirable ? J Pediatr 1976;88:1074-6.","journal-title":"J Pediatr"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1136\/bmj.280.6214.604","article-title":"Timing of pre-breakfast insulin injection and postprandial metabolic control in diabetic children","volume":"280","author":"Kinmonth, A.L.; Baum, J.D.","year":"1980","unstructured":"Kinmonth AL, Baum JD. Timing of pre-breakfast insulin injection and postprandial metabolic control in diabetic children. Br Med Jf 1980; 280:604-6.","journal-title":"Br Med Jf"},{"key":"ref_30","first-page":"493","article-title":"A simple and rational twice daily injection regime: distinction between basal and meal insulin requirements","volume":"48","author":"Phillips, M.; Simpson, R.W.; Holman, R.R.; Turner, R.C.","year":"1979","unstructured":"Phillips M, Simpson RW, Holman RR, Turner RC. A simple and rational twice daily injection regime: distinction between basal and meal insulin requirements. Q J Med 1979;48:493-506.","journal-title":"Q J Med"},{"author":"Accepted 24June 1980)","key":"ref_31","unstructured":"(Accepted 24June 1980)"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.281.6237.414","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.281.6237.414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T21:29:02Z","timestamp":1765402142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.281.6237.414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1980,8,9]]},"references-count":31,"journal-issue":{"issue":"6237","published-online":{"date-parts":[[1980,8,9]]},"published-print":{"date-parts":[[1980,8,9]]}},"alternative-id":["10.1136\/bmj.281.6237.414"],"URL":"https:\/\/doi.org\/10.1136\/bmj.281.6237.414","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"type":"print","value":"0007-1447"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1980,8,9]]}}}