scholarly journals Comparison of two insulin injection methods on control of type 2 diabetes; is the new protocol effective or not?

2021 ◽  
Vol 7 (1) ◽  
pp. e10-e10
Author(s):  
Mohammad Ali Bayani ◽  
Hojjatollah Ghorbani ◽  
Roghayeh Akbari
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Insulin Dose ◽  
Insulin Injection ◽  
Regular Insulin ◽  
Diabetic Patients ◽  
Injection Methods ◽  
The Mean

Introduction: Type 2 diabetes is a progressive disease with a significant risk for developing late complications. Objectives: This study aimed to determine if the discharge NPH and regular insulin doses of conventional insulin therapy protocol in which optimal glycemic control can be achieved are similar to NPH and regular insulin doses at beginning of the insulin protocol or not. In other words, we aimed to compare two insulin injection methods on the control of type 2 diabetes. Patients and Methods: This cross-sectional study was performed on hospital records of type II diabetic patients admitted for insulin therapy with the conventional protocol from 2008-2013. Treatment was initiated with the following proportions; morning NPH: 44%, morning regular dosage: 22%, evening NPH dosage: 17% and evening regular dosage: 17%. Insulin doses of the discharge day in which optimal glycemic control has been achieved were recorded and based on their mean, a protocol was made. Finally, two groups were categorized. Group 1 consisted of patients whose discharge insulin dose was in the range of the mean data of the study (±2 IU/mL) and patients whose discharge insulin dose was in accordance with the conventional protocol (±2 IU/mL) participated in group 2. Results: At discharge day, the mean morning NPH dose was 34.2±6.69, morning regular: 23.8±6.36, evening NPH: 21.26±6.75 and evening regular: 20.74±5.51. The discharge insulin ratios of the conventional protocol were similar to that of the admission ratios in only 17.7% of the patients. Only 34.5% of the patients could include in the new protocol and 50% of them didn’t fit any protocol. Conclusion: It is suggested to inject one-third of the total daily insulin need as NPH in the morning and divide the remained two-thirds between morning regular, evening NPH and evening regular equally. This may decrease the length of hospital stay and decrease the time to reach the desired glycemic control.

scholarly journals Insulin therapy is a personalized approach to glycemic management in diabetes

2020 ◽  
Vol 92 (12) ◽  
pp. 201-206
Author(s):  
T. Yu. Demidova ◽  
V. V. Titova
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Glucose Variability ◽  
Diabetic Patients ◽  
Duration Of Action ◽  
Chronic Hyperglycemia

Type 2 diabetes is characterized by chronic hyperglycemia and varying degrees of insulin resistance and insulinopenia. Achieving targeted glycemic control in diabetic patients is important to reduce the risk of late complications, and many patients with type 2 diabetes ultimately require insulin therapy to maintain adequate glycemic control. Timely administration of insulin can prevent the progression of diabetes, reduce the development of complications, and have fewer side effects. Basal insulin is the preferred option in most cases when glycemic control is not achieved. However, there is considerable therapeutic inertia in clinical practice, both with respect to initiation of insulin therapy and titration of the basal insulin dose. The longer duration of action, reduced glucose variability and a lower risk of hypoglycemia seen with the latest generation of basal insulin analogs compared to the previous generation simplify titration and may increase patient compliance.

scholarly journals The Effect of Health Education on Control Glycemic at Type 2 Diabetes Mellitus Patients

2020 ◽  
Vol 8 (E) ◽  
pp. 133-137
Author(s):  
Rusdiana Rusdiana ◽  
Maya Savira ◽  
Sry Suryani Widjaja ◽  
Dedi Ardinata
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Education ◽  
Diabetic Patients ◽  
The Mean ◽  
Educational Course

AIM: The aim of this study was to evaluate the effect of short-term education on glycemic control (glycated hemoglobin [HbA1c] and fasting blood sugar [FBS]) among type 2 diabetes mellitus patients attending to primary health care (PHC) in Medan Johor of North Sumatera, Indonesia. METHODS: The study was performed on type 2 diabetes mellitus patients in Johor PHC, Medan of North Sumatera, on 40 patients with type 2 diabetes mellitus. We took the samples of all the patients of type 2 diabetes mellitus who attend PHC in Medan Johor. The patients received for 3 months intervention by education. An educational course of diabetes together with exercise training and nutritional education was designed for the study population in order to increase the patients’ knowledge and attitude toward diabetes and to increase their participation in the self-monitoring of glycemic control. Samples of FBS and HbA1c were recorded for each patient at the time of the baseline survey, then health education was conducted to the diabetic patients of both sexes attending PHC. The patients received standard advice on diet management and variation about activity. We put HbA1c <6.5% as cut limit for the control of diabetes mellitus. RESULTS: All 40 type 2 diabetes patients completed the educational course. The mean of age of the samples is 62.53 years old, the mean of body mass index was 24.81 kg/m, and the mean of waist size was 92.15 cm. Before the education, the mean of FBS level was 238.83 mg/dl and the mean of Hba1c value is 8.90%. After education, the FBS was 216.88 mg/dl, the mean of HbA1c value was 8.74%. CONCLUSION: The effect of health education in Johor Public Health Care Medan city reduced glycemic control (FBS) in type 2 diabetes mellitus patients, North Sumatera, Indonesia.

scholarly journals Reported Benefits of Insulin Therapy for Better Glycemic Control in Type 2 Diabetic Patients–-Is this Applicable in Saudi Patients?

2016 ◽  
Vol 9 ◽  
pp. CMED.S38077 ◽  
Author(s):  
Wafaa AlSaggaf ◽  
Mohammed Asiri ◽  
Balgees Ajlan ◽  
Alaa Bin Afif ◽  
Roaa Khalil ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Treatment Plan ◽  
Combined Therapy ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Oral Hypoglycemic Agents ◽  
The Mean

Aim To compare the effect of different treatment regimens (oral hypoglycemic agents [OHGs], insulin therapy, and combination of both) on glycemic control and other cardiometabolic risk factors in type 2 diabetes mellitus (T2DM) patients in Saudi. Subjects and Methods Patients with T2DM, but no serious diabetic complications, were randomly recruited from the diabetes clinics at two large hospitals in Jeddah, Saudi Arabia, during June 2013 to July 2014. Only those without change in treatment modality for the last 18 months were included. Blood pressure and anthropometric measurements were measured. Treatment plan was recorded from the patients' files. Fasting blood sample was obtained to measure glucose, HbA1c, and lipid profile. Results A total of 197 patients were recruited; 41.1% were men and 58.9% were women. The mean (±SD) age was 58.5 ± 10.5 years. Most patients (60.7%) were on OHGs, 11.5% on insulin therapy, and 27.7% were using a combination of insulin and OHGs. The mean HbA1c was lower in patients using OHGs only, compared with means in those using insulin, or combined therapy in patients with disease duration of #10 years ( P = 0.001) and also in those with a longer duration of the disease ( P < 0.001). A lower mean diastolic and systolic blood pressure was found among patients on insulin alone ( P < 0.01). No significant differences were found in lipid profiles among the groups. Conclusion Insulin therapy, without adequate diabetes education, fails to control hyperglycemia adequately in Saudi T2DM patients. There is a challenge to find out reasons for poor control and the ways as to how to improve glycemic control in T2DM.

scholarly journals Evaluation of the relationship between different factors of self-management and control of diabetes in diabetic patients group

2021 ◽  
Vol 6 (1) ◽  
pp. e18-e18
Author(s):  
Sara Afshari ◽  
Narges Kalhor ◽  
Mostafa Vahedian ◽  
Rasoul Shajari ◽  
Soroush Sharifimoghadam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Health Care Use ◽  
Self Management ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Control Of Diabetes ◽  
The Mean ◽  
And Control

Introduction: Diabetes is one of the most common chronic diseases that severely affects the quality of life. Self-Management and glycemic control minimize the development and progression of diabetes’s complications. Objectives: We aimed to evaluate self-care behaviors and their relationship with hemoglobin A1c (HbA1c) level in patients with type 2 diabetes, using the Diabetes Self-Management Questionnaire (DSMQ). Patients and Methods: This is a cross-sectional study conducted on type 2 diabetic patients referred to the Shahid Beheshti hospital of Qom. A total of 325 patients with type-2 diabetes participate in the study. Diabetes self-management parameters were assessed using the translated (Persian) version of the DSMQ. Results: The mean score of self-management (±SD) in patients was 26.82 (±9.43). In addition, the mean HbA1c and fasting blood sugar (FBS) levels of the participants respectively were 8.35 (±1.97) and 187.25 (±77.51). There was a significant inverse correlation between self-management score metabolic control indices. (P<0.001). Health care use subscales have been best associated with better glycemic control (P<0.001) and physical activity had the least effect on it (P<0.001). Conclusion: The findings of this study revealed that there is a significant relationship between self-management indicators and control of diabetes.

scholarly journals The role of sodium-glucose cotransporter 2 inhibitors in the treatment of type 2 diabetes: from clinical research to real practice

2020 ◽  
Vol 48 ◽  
Author(s):  
I. V. Misnikova ◽  
Yu. A. Kovaleva ◽  
V. A. Gubkina
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Cardiovascular Diseases ◽  
Kidney Disease ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Insulin Dose ◽  
Therapy Regimen ◽  
Sodium Glucose Cotransporter

In type 2 diabetes mellitus (T2DM), the development and progression of cardiovascular diseases occurs, which allows it to be considered as a cardiorenal metabolic syndrome. This should be taken into account when choosing hypoglycemic drugs. Patients with T2DM receiving insulin therapy often have a long history of diabetes, cardiovascular disease, chronic kidney disease, obesity, and need to be prescribed high doses of insulin and/or complex insulin therapy regimens to maintain glycemic control, which does not always lead to the achievement of target levels of glycemia and glycated hemoglobin (HbA1c). Adding to any insulin therapy regimen drugs from the class of sodium-glucose cotransporter type 2 inhibitors (SGLT-2), which have proven their cardio- and renoprotective properties, seems to be a rational combination in patients with T2DM and may have a number of advantages. The article presents 4 clinical examples of dapagliflozin administration, a drug from the SGLT2 class, to patients who are on insulin therapy, having T2DM with a  long history (10–26 years), as well as cardiovascular diseases, chronic kidney disease, and obesity. Dapagliflozin administration allowed to improve glycemic control, to stabilize the insulin dose, as well as reduce body weight without increasing the frequency of serious episodes of hypoglycemia in patients who initially received large doses of insulin. In the long term, we can expect reduction of the progression of cardiovascular risks and the risks of hospitalization due to existing complications of the disease.

scholarly journals Supplementation disrupts the circannual rhythm of vitamin D: A retrospective analysis

2020 ◽  
Vol 11 (3) ◽  
pp. 108-115
Author(s):  
Özgür Aydın
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Therapy Group ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: MPV and PDW are vascular complications markers and improved glycemic control levels are correlated those indicators in patients with type 2 Diabetes Mellitus. The aim of in this study, MPV and PDW levels were compared type 2 diabetic patients treated with oral antihyperglycemic agent and insulin. Methods: This study was performed retrospectively on type 2 DM patients who were admitted to Ankara Atatürk Training and Research Hospital. 118 randomly selected patients were divided into 3 groups that were non-diabetic (Group 1), who received OAD therapy (Group 2), and those who received insulin therapy (Group 3). HbA1c, MPV, PDW levels were collected, analyzed and compared with each other. Results: MPV and PDW values were increased in type 2 DM patients compared to the control group (Group 2; p <0.001 and Group 3 p <0.001, respectively). There was no statistically significant difference between MPV and PDW values in patients treated OAD and insulin therapy (p=0.736 ve p=0.360 respectively). A statistically significant positive correlation was found between HbA1c values and MPV (p <0.001) and PDW (p <0.001) values. Conclusions: In our study, no significant difference was found bet-ween MPV and PDW values of patients using insulin and oad. Early initiation of conventional insulin therapy in patients with type 2 diabetes provides good glycemic control. Rational drug use in accordance with the guidelines; gains importance in treatment success. Skipping this factor may reduce the efficiency of other efforts in relation to rational treatment.

scholarly journals Evaluation of MPV and PDW levels by using antihyperglycemic drugs in type 2 DM patients

2020 ◽  
Vol 11 (3) ◽  
pp. 102-107
Author(s):  
Hacer Dinçoğlu ◽  
İrep Eray
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Therapy ◽  
Therapy Group ◽  
Diabetic Patients ◽  
Type 2 Dm ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

Objectives: MPV and PDW are vascular complications markers and improved glycemic control levels are correlated those indicators in patients with type 2 Diabetes Mellitus. The aim of in this study, MPV and PDW levels were compared type 2 diabetic patients treated with oral antihyperglycemic agent and insulin. Methods: This study was performed retrospectively on type 2 DM patients who were admitted to Ankara Atatürk Training and Research Hospital. 118 randomly selected patients were divided into 3 groups that were non-diabetic (Group 1), who received OAD therapy (Group 2), and those who received insulin therapy (Group 3). HbA1c, MPV, PDW levels were collected, analyzed and compared with each other. Results: MPV and PDW values were increased in type 2 DM patients compared to the control group (Group 2; p <0.001 and Group 3 p <0.001, respectively). There was no statistically significant difference between MPV and PDW values in patients treated OAD and insulin therapy (p=0.736 ve p=0.360 respectively). A statistically significant positive correlation was found between HbA1c values and MPV (p <0.001) and PDW (p <0.001) values. Conclusions: In our study, no significant difference was found between MPV and PDW values of patients using insulin and oad. Early initiation of conventional insulin therapy in patients with type 2 diabetes provides good glycemic control. Rational drug use in accordance with the guidelines; gains importance in treatment success. Skipping this factor may reduce the efficiency of other efforts in relation to rational treatment.

scholarly journals Patterns and Predictors of Long-Term Glycemic Control in Patients with Type 2 Diabetes

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Mohsen Janghorbani ◽  
Masoud Amini
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Clinic Visit ◽  
Stepwise Multiple Regression ◽  
Diabetic Patients ◽  
Initial Visit ◽  
The Mean

Aims/Introduction. To describe patterns of long-term glycemic control among patients with type 2 diabetes in Isfahan, Iran and identify factors associated with glycemic control. Methods. During the mean (standard deviation (SD)) follow-up period of 8.4 (4.2) (range 1–18) years, 4,582 patients with type 2 diabetes have been examined to determine glycemic changes. Their glycated hemoglobin (GHb) at the last clinic visit was compared with the initial visit data. The mean (SD) age of participants was 49.3 (9.6) years with a mean (SD) duration of diabetes of 5.0 (5.1) years at initial registration. Results. Mean (SD) GHb was 8.7% (2.3) at baseline and 7.9% (1.9) at the study end and decreased by mean of 0.8% (95% confidence interval (CI) 0.74, 0.87; P < 0.001) and varied by the severity of baseline GHb. 74.6% at the initial visit versus 64.4% at the last clinic visit had GHb values above the target level of 7.0%. Using a stepwise multiple regression models, age, higher GHb, FPG, follow-up period, and number of follow-up visits increased and higher systolic BP and female gender significantly decreased the percent glycemic change. Conclusions. This study highlights that more than 64.4% of the patients have GHb values higher than 7.0% at last clinic visit andindicatesthe difficult challenges physicians face when treating their patients with type 2 diabetes. Clinical efforts should focus on more effective methods for glycemic control in diabetic patients.

scholarly journals Association of serum vitamin D level with glycemic control in patients with type 2 diabetes mellitus

2020 ◽  
Vol 24 (3) ◽  
pp. 395-400
Author(s):  
Dler Kakil ◽  
Mohammed Meena
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Diabetic Patients ◽  
The Mean

Background and objective: Vitamin D deficiency appears to be related to the development of diabetes mellitus type 2 and metabolic syndrome. This study aimed to assess the association between the level of 25-hydroxy vitamin D{25(OH)D3 and the glycemic control in patients with type 2 diabetes. Methods: This case-control study involved 240 participants divided into two groups, 119 patients with type 2 diabetic mellitus and 120 healthy individuals as a control group. The study was conducted in Layla Qassim Diabetic Center in Erbil from March 2018 to March 2019. The data were collected from all the cases, including history and physical examination, using a specially designed questionnaire. From all cases, blood was taken, and samples were sent to the laboratory for serum vitamin D3 level estimation. Results: From the total of 240 participants, the mean age of cases was 54.04 ± 10.56 years and of controls was 53.12 ± 9.84 years. The mean serum vitamin D3 level of the cases was 9.21 ± 5.69ng/ml, and it was non-significantly (P = 0.3) higher than the control (8.61±4.57)ng/ml. Both groups were within the vitamin D deficient range. Vitamin D level was non-significantly deficient in 84 (70.6%) of diabetic patients compared to 89(73.6%) of control. There was a non-significant difference in vitamin D level in poorly controlled diabetic patients compared to well-controlled diabetic patients (P = 0.584). Conclusion: No significant association was detected between vitamin D level and glycemic control. Keywords: Type 2 diabetes mellitus; Vitamin D3 level; Glycemic control.

scholarly journals SAT-648 Flash Glucose Monitoring Helps Achieve Better Glycemic Control Than Conventional Self-Monitoring of Blood Glucose in Non-Insulin-Treated Type 2 Diabetes: A Randomized Controlled Trial

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Eri Wada ◽  
Takeshi Onoue ◽  
Tomoko Kobayashi ◽  
Tomoko Handa ◽  
Ayaka Hayase ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Self Monitoring ◽  
Flash Glucose Monitoring ◽  
Glucose Levels ◽  
The Mean

Abstract Background and aims: Flash glucose monitoring (FGM) is a novel system with which glucose levels are monitored and has been reported to improve glucose variability and glycemic control in type 1 and type 2 diabetes patients treated with insulin. The present study aimed to evaluate the effects of FGM and conventional self-monitoring of blood glucose (SMBG) on glycemic control in patients with non-insulin-treated type 2 diabetes. Reseach design and Methods: In this 24-week, multicenter, open-label, randomized (1:1), parallel group study, non-insulin-treated type 2 diabetic patients at 5 hospitals in Japan were randomly assigned to the FGM (n = 49) or SMBG (n = 51) groups and were provided FGM or SMBG devices for 12 weeks. The primary outcome was change in glycated hemoglobin (HbA1c) level. This trial is registered with UMIN-CTR (UMIN000026452). Results: Forty-eight participants in the FGM group and 45 in the SMBG group completed the study. The mean HbA1c levels were 7·83% (SD 0·25) in the FGM group and 7·84% (SD 0·27) in the SMBG group at baseline, and the values were reduced in both FGM (−0·43%; 95% confidence interval [CI], −0·57 to −0·28; p &lt; 0·0001) and SMBG groups (−0·30%; 95% CI −0·48 to −0·13; p = 0·001) at 12 weeks. On the other hand, HbA1c was significantly decreased from baseline values in the FGM group, but not in the SMBG group at 24 weeks (FGM: −0·46%, 95% CI −0·59 to −0·32, p &lt; 0·0001; SMBG: −0·17%, 95% CI −0·05 to 0·11, p = 0·124); a significant between-group difference was also observed (difference −0·29%, 95% CI −0·54 to −0·05; p = 0·022). Diabetes Treatment Satisfaction Questionnaire score was significantly improved, and the mean glucose levels, standard deviation of glucose, mean amplitude of glycemic excursions, and duration of hyperglycemia were significantly decreased in the FGM group compared with the SMBG group. Conclusions: Glycemic control was better with FGM than with SMBG after cessation of glucose monitoring in non-insulin-treated type 2 diabetic patients.

Sign in / Sign up

Export Citation Format

Share Document