科研之友
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摘要
Background 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 (HbAlc) was 11.3 (2.3) % and decreased to 6.3 (1.4) % in 6 months, with HbAlc < 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 HbA(1c) (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 (63% 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.
- 出版日期2014-3-20
