Dilute Insulin Publications

Young children with a low total daily dose (TDD) might benefit from dilute insulin.

CamAPS FX is CE marked for use from 5 to 350 insulin units per day, however it may be worth considering diluting insulin if TDD is below 8 units per day and especially in those newly diagnosed and likely to honeymoon.

ISPAD Chapter 9: Insulin Treatment in Children and Adolescence with Diabetes

Point 17: Insulin Concentrations

The most widely available insulin concentration is 100 IU/mL (U 100).
Treatment with U 40 (40 IU/mL), U50 or other concentrations such as U500 is also acceptable, subject to availability and special needs.
Care must be taken to ensure that the same concentration is supplied each time new supplies are received.
Very young children occasionally require insulin diluted with diluent obtained from the manufacturer, but special care is needed in dilution and drawing up the insulin into the syringe.
Rapid-acting insulin can be diluted to U10 or U50 with sterile NPH diluent and stored for 1 month for use in pumps for infants or very young children.

Elleri 2014 Overnight Closedloop In Young Children Dilute Vs Std Insulin [571.81 KB]

ISPAD Consensus 2017 Managing Diabetes In Preschool Children [1.82 MB]

ISPAD Guidelines 2018 Chapter 9 Insulin Treatment [2.21 MB]

Ruan 2015 Pharmacokinetics Of Diluted U20 Insulin [257.53 KB]