Vol 12, No 1 (2011): Practical Diabetology
Research paper
Published online: 2011-04-28
Accomplishment of the proper metabolic control with regard to the PDA guidelines in type 2 diabetes patients before and after introduction of insulinotherapy
Diabetologia Praktyczna 2011;12(1):21-27.
Abstract
INTRODUCTION. Gradual exhaustion of secretion
abilities of b cell in diabetes type 2 is inexorably connected
with worse metabolic control and necessity
to incorporate insulin therapy. The aim was to assess
the improvement of metabolic control after insulin
treatment initiation.
MATERIAL AND METHODS. The research was conducted on a group of 52 patients with diabetes type 2 — 30 female and 22 male, aged 44–79 (mean 63.1 ± 10.1). The treatment of patients in mentioned group was intensified by administration of insulin along with so far administered oral medicines, and exposing them to 8 ± 1.5 months long observation.
RESULTS. After administration of insulin along with so far administered oral medicines a significant average reduction of HbA1c level was achieved: from 7.9% to 7.5%, which means that percentage of patients with HbA1c £ 7.0% increased from 28.8% (n = = 15) to 44.3% (n = 23). The percentage of patients with HbA1c £ 6.5% remained unchanged and amounted to 19.2% (n = 10). There was observed an increase of percentage of patients with BP systolic < 130 mm Hg from 19.2% (n = 10) to 30.8% (n = 16) and BP diastolic < 80 mm Hg from 15.4% (n = 8) to 26.9% (n = 14). When it comes to lipid management the researchers observed slight increase of percentage of patients who met compensation criteria: total cholesterol concentration < 175 mg/dL from 34.6% (n = 18) to 40.4% (n = 21), HDL > 40 mg/dL from 55.8% (n = 29) to 67.3% (n = 35), LDL < 100 mg/dL from 38.5% (n = 20) to 40.4% (n = 21) and TG < 150 mg/dL from 50% (n = 26) to 51.9% (n = 27).
CONCLUSIONS. The results of the study confirmed that insulin therapy had a positive impact on the level of metabolic control in patients with unstable type 2 diabetes, which was visible after only a few months of treatment. These results should encourage both patients and their doctors to opt for insulin therapy. (Diabet. Prakt. 2011; 12, 1: 21–27)
MATERIAL AND METHODS. The research was conducted on a group of 52 patients with diabetes type 2 — 30 female and 22 male, aged 44–79 (mean 63.1 ± 10.1). The treatment of patients in mentioned group was intensified by administration of insulin along with so far administered oral medicines, and exposing them to 8 ± 1.5 months long observation.
RESULTS. After administration of insulin along with so far administered oral medicines a significant average reduction of HbA1c level was achieved: from 7.9% to 7.5%, which means that percentage of patients with HbA1c £ 7.0% increased from 28.8% (n = = 15) to 44.3% (n = 23). The percentage of patients with HbA1c £ 6.5% remained unchanged and amounted to 19.2% (n = 10). There was observed an increase of percentage of patients with BP systolic < 130 mm Hg from 19.2% (n = 10) to 30.8% (n = 16) and BP diastolic < 80 mm Hg from 15.4% (n = 8) to 26.9% (n = 14). When it comes to lipid management the researchers observed slight increase of percentage of patients who met compensation criteria: total cholesterol concentration < 175 mg/dL from 34.6% (n = 18) to 40.4% (n = 21), HDL > 40 mg/dL from 55.8% (n = 29) to 67.3% (n = 35), LDL < 100 mg/dL from 38.5% (n = 20) to 40.4% (n = 21) and TG < 150 mg/dL from 50% (n = 26) to 51.9% (n = 27).
CONCLUSIONS. The results of the study confirmed that insulin therapy had a positive impact on the level of metabolic control in patients with unstable type 2 diabetes, which was visible after only a few months of treatment. These results should encourage both patients and their doctors to opt for insulin therapy. (Diabet. Prakt. 2011; 12, 1: 21–27)
Keywords: type 2 diabetesmetabolic control levelinsulinotherapyglycosylated hemoglobin (HbA1c)PDA (Polish Diabetes Association) guidelines