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[Medium-term results of a Day Hospital insulin therapy program for patients with type 2 diabetes mellitus].

AbstractBACKGROUND AND OBJECTIVE:
The profile of the patient with type 2 diabetes mellitus (DM2) who requires insulin therapy is very diverse as are the results of this intervention and short/middle-term patient management. We evaluated the midterm results of an outpatient program starting insulin therapy with≥2 insulin injections/day in terms of metabolic control in different groups of patients.
PATIENTS AND METHOD:
We analyzed prospectively 131 patients with DM2, without previous insulin treatment, who were prescribed treatment with≥2 insulin injections/day and who were enrolled in a specific ambulatory program in order to start insulin therapy in a Day Hospital for 6 months.
RESULTS:
The initial glycosylated hemoglobin (HbA1c) was 11.3 (2.3) % and decreased to 6.3 (1.4) % in 6 months, with HbA1c<7% in 72.5% of them. The group of recently diagnosed patients (<3 months, symptomatic severe hyperglycemia, D-group) were younger (57.1 [10.8] vs 64.2 [12.1] years; P<.01) and had a higher starting HbA1c (12.1 [1.8] vs 10.5 [2.5] %; P<.001) than patients included in the program for oral antidiabetic drugs' failure (F-group). At the end of the program 50% of D-group patients did not need insulin (6.3% on F-group [P<.001]). There were no significant differences in either of 2 groups at study ends according to the final treatment scheme.
CONCLUSIONS:
Counselling patients with DM2 to start insulin with more than one injection per day in Day Hospital setting achieves and maintains a good metabolic control in the medium term in different patient profiles. Among symptomatic and recently diagnosed patients, insulin therapy can be stopped in 50% of them at the medium term.
AuthorsCarmen Quirós, Antonio J Amor, Ana M de Hollanda, Gemma Yago, Pilar Ara, Ignacio Conget
JournalMedicina clinica (Med Clin (Barc)) Vol. 142 Issue 6 Pg. 243-7 (Mar 20 2014) ISSN: 1578-8989 [Electronic] Spain
Vernacular TitleResultados a medio plazo de un programa de insulinización en régimen de Hospital de Día para pacientes con diabetes tipo 2.
PMID23540385 (Publication Type: Journal Article, Observational Study)
CopyrightCopyright © 2012 Elsevier España, S.L. All rights reserved.
Chemical References
  • Glycated Hemoglobin A
  • Insulin
Topics
  • Adult
  • Age Distribution
  • Aged
  • Body Weight
  • Day Care, Medical
  • Diabetes Complications (epidemiology)
  • Diabetes Mellitus, Type 2 (blood, drug therapy)
  • Female
  • Glycated Hemoglobin (analysis)
  • Humans
  • Insulin (therapeutic use)
  • Male
  • Middle Aged
  • Outpatient Clinics, Hospital
  • Prospective Studies
  • Treatment Outcome

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