Glycemic Control in Switching Insulin-based Regimen Among Type 2 Diabetic Patients

Pradana Soewondo, Imam Subekti

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Appropriate diet and physical activity, maintaining a healthy body weight and propercontrol of diabetes using oral anti diabetic (OAD) in people with diabetes type 2 will helpreduce its complications. However, some advance diabetic cases need insulin-based regimen toaggressively lower blood glucose level. Local data was insufficient to determine whether type 2diabetes patients on insulin were indeed attaining glycemia goals. The aim of this study was toassess the clinical response of type 2 diabetic patients who were switched to another insulinregimen to achieve glycemic control. The study was performed as a non-interventional prospective disease registry that mirror real life management of these subjects after a 3 month follow up. To assess the clinical response, we performed measurement of fasting blood glucose level, HbA1c, waist circumference and body weight. One hundred and fifteen type 2 diabetes patients who were already on insulin therapy with unsatisfactory control of glycaemia parameters were admitted in this study of an actual clinical setting. Only 93 cases have been examined in a 3 month follow up. Premix, Short-acting and Intermediate-acting insulin were the most popular insulin-based regimens that previously been prescribed, while basal analogue insulin is the most common regimen for switching therapy. The newly prescribed insulin-based regimen showed significant reduction of important glycaemia parameters such as fasting blood glucose level and HbA1c. Serum blood glucose was decreased 61.76 mg/dL (p<0.001) and the level of HbA1c was also decreased 1.39 unit (p<0.001). In addition, waist circumference was significantly reduced for 0.70 cm (p=0.041). However, there was a slight increase of body weight althoughnot statistically significant (p=0.389). We concluded that switching insulin-based regimen for unsatisfactory although glycemic control patient gave the probability to improve clinical response.
Original languageEnglish
JournalJournal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Publication statusPublished - 2011


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