Literature DB >> 16799401

Insulin initiation in type 2 diabetic patients admitted in hospital in France and follow-up at 1 year.

D Raccah1, H Hanaire-Broutin, C Sert-Langeron, S Brin, G Chabrier, P M Fontaine, M Rodier, L Vaur, E Eschwege.   

Abstract

OBJECTIVES AND METHODS: The IDAHO 2 epidemiological survey was conducted in departments of diabetology in insulin-naïve type 2 diabetics for whom insulin was initiated. The objective was to assess the patients' profile, the treatments proposed during hospital stay and after one year.
RESULTS: 797 patients were analysed. Their characteristics were: age 64+/-12 years, 49% males, weight: 78+/-17 kg, BMI: 29+/-6 kg/m2, diabetes duration 11 years, prevalence of complications: 68%, fasting blood glucose 13+/-6 mmol/l, HbA1c: 10+/-2.2%; treatment prior to insulin comprised: at least 2 OHA: 71% of cases, one: 21%, no OAD: 8%. At hospital discharge, 54% of the patients used basal insulin. After 1 year, 670 continued on insulin. The insulin initiation was accompanied by a decrease in the FBG level (baseline: 13+/-6 mmol/l; final: 8.5+/-2.75 mmol/l; P<0.0001) and a HbA1c improvement (baseline: 10+/-2.2%; final: 7.9+/-1.4%; P<0.0001). This was observed du-ring the first 6 months (HbA1c: 7.8%, P<0.0001 versus baseline). 80% of the patients remained on the same insulin regimen after 1 year: 35% had 1 injection/day, 44% had 2, 12% had 3 and 9% had a complex regimen. The weight gain, the final daily dose and hypoglycaemias increased with the number of injections. The mean daily insulin dose was 33 U/day (24 U with 1 injection/day).
CONCLUSION: The IDAHO study shows that insulin is effective in type 2 diabetics however, management is inadequate with insulin therapy being initiated too late and at doses which are low after one year.

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Year:  2006        PMID: 16799401     DOI: 10.1016/s1262-3636(07)70275-6

Source DB:  PubMed          Journal:  Diabetes Metab        ISSN: 1262-3636            Impact factor:   6.041


  3 in total

1.  Effect of hospital admission on glycemic control 1 year after discharge.

Authors:  Nancy J Wei; Richard W Grant; David M Nathan; Deborah J Wexler
Journal:  Endocr Pract       Date:  2012 Jul-Aug       Impact factor: 3.443

2.  Impact of inpatient diabetes management, education, and improved discharge transition on glycemic control 12 months after discharge.

Authors:  Deborah J Wexler; Catherine C Beauharnais; Susan Regan; David M Nathan; Enrico Cagliero; Mary E Larkin
Journal:  Diabetes Res Clin Pract       Date:  2012-10-01       Impact factor: 5.602

3.  Studying the Hurdles of Insulin Prescription (SHIP): development, scoring and initial validation of a new self-administered questionnaire.

Authors:  Luc Martinez; Silla M Consoli; Louis Monnier; Dominique Simon; Olivier Wong; Bernard Yomtov; Béatrice Guéron; Khadra Benmedjahed; Isabelle Guillemin; Benoit Arnould
Journal:  Health Qual Life Outcomes       Date:  2007-08-29       Impact factor: 3.186

  3 in total

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