Introduction of insulin therapy in patients with type 2 diabetes mellitus - is not it too late?

Abstract

INTRODUCTION. The aim of the study was to determine the level of admission A1c in type 2 diabetes mellitus patients referred to the hospital due to various internal diseases. Moreover, the patient’s knowledge about the principle of type 2 diabetes mellitus management monitoring was evaluated.
MATERIAL AND METHODS. Study population consisted of 86 type 2 diabetes mellitus patients referred to the hospital due to other reasons than diabetes decompensation. The admission A1c values were determined in all patients. In addition, all patients were asked to complete a questionnaire consisting of several questions including: duration of type 2 diabetes mellitus, mode of treatment and monitoring of type 2 diabetes mellitus management.
RESULTS. The patients’ mean age was 65 ± 11.07 years, mean duration of type 2 diabetes mellitus 7.5 ± 6.4 years and the mean A1c value 9.46% ± 1.92%. A1c value was > 9.5% in as many as 38% of patients. None of the patients have had A1c measured over the past 3-6 months and most of them have never heard about this glycemic control marker. Before hospitalisation type 2 diabetes was managed only with diet in 10 patients. Twenty patients received metformin and 13 sulphonylurea (SU) as monotherapy. Thirty nine patients were treated with metformin and SU, 2 with SU and acarbose, 1 with metformin and acarbose, and 1 subject received combination of metformin, SU and acarbose.
CONCLUSIONS. These findings indicate that A1c is not regularly determined in type 2 diabetes mellitus patients as recommended by the Polish Diabetes Association. It may at least partially explained why the patients with type 2 diabetes mellitus are not switched by general practitioners on insulin therapy sooner.
(Diabet. Prakt. 2010; 11, 4: 125-129)