Vol 2, No 3 (2001): Practical Diabetology
Research paper
Published online: 2001-06-15
The effect of intensive insulin therapy on the body mass index and lipids in patients with type 1 diabetes mellitus - retrospective analysis
Diabetologia Praktyczna 2001;2(3):203-208.
Abstract
OBJECTIVE. The purpose of the study was a retrospective
analysis of intensive insulin therapy in patients
with type 1 diabetes mellitus with special consideration
of its effects on the body mass index (BMI), lipid
profile, diabetes control and daily insulin requirement.
RESEARCH DESING AND METHODS. Case histories of type 1 diabetics hospitalised in the Department of Metabolic Diseases between 1995 and 1999 were analysed. Each hospitalised patient received intensive insulin therapy (IIT) and attended a course on diabetes education.
RESULTS. In 72 patients (37 women and 35 men) with a mean age of 31,85 ± 11,88 years the results of control examinations were evaluated at 1 to 4 years after IIT. BMI was found to increase significantly (22,84 ± 3,05 vs. 24,07 ± 3,29 kg/m2, p < 0,001). Total cholesterol was significantly higher (4,75 ± ± 1,10 vs 5,07 ± 1,21 mmol/l, p < 0,05), similar to HDL cholesterol (1,44 ± 0,49 vs. 1,63 ± 0,38 mmol/l, p <0,05). No significant differences were seen in triglycerides, LDL cholesterol and atherogenic index. At 1–4 years after IIT diabetes control was significantly improved (HbA1c: 8,50 ± 2,37 vs. 7,40 ± 1,69%, p < 0,01). There was a significant positive correlation between BMI and LDL cholesterol (r = 0,41, p < 0,005) and between HbA1c and triglycerides (r = 0,53, p < 0,05).
CONCLUSIONS. The retrospective analysis shows that IIT in patients with type 1 diabetes mellitus improved glycaemia control. Body weight gain expressed as BMI was an unfavourable effect. The increased BMI was not associated with the atherogenic lipid profile based upon increased HDL cholesterol. The favourable changes in the lipid profile despite the increased BMI may result from improved diabetes control due to IIT.
RESEARCH DESING AND METHODS. Case histories of type 1 diabetics hospitalised in the Department of Metabolic Diseases between 1995 and 1999 were analysed. Each hospitalised patient received intensive insulin therapy (IIT) and attended a course on diabetes education.
RESULTS. In 72 patients (37 women and 35 men) with a mean age of 31,85 ± 11,88 years the results of control examinations were evaluated at 1 to 4 years after IIT. BMI was found to increase significantly (22,84 ± 3,05 vs. 24,07 ± 3,29 kg/m2, p < 0,001). Total cholesterol was significantly higher (4,75 ± ± 1,10 vs 5,07 ± 1,21 mmol/l, p < 0,05), similar to HDL cholesterol (1,44 ± 0,49 vs. 1,63 ± 0,38 mmol/l, p <0,05). No significant differences were seen in triglycerides, LDL cholesterol and atherogenic index. At 1–4 years after IIT diabetes control was significantly improved (HbA1c: 8,50 ± 2,37 vs. 7,40 ± 1,69%, p < 0,01). There was a significant positive correlation between BMI and LDL cholesterol (r = 0,41, p < 0,005) and between HbA1c and triglycerides (r = 0,53, p < 0,05).
CONCLUSIONS. The retrospective analysis shows that IIT in patients with type 1 diabetes mellitus improved glycaemia control. Body weight gain expressed as BMI was an unfavourable effect. The increased BMI was not associated with the atherogenic lipid profile based upon increased HDL cholesterol. The favourable changes in the lipid profile despite the increased BMI may result from improved diabetes control due to IIT.
Keywords: type 1 diabetesintensive insulin therapybody mass indexlipids