Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice.

Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Research Abstract Details 

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Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Abstract Text:

Markku ,Tapani ,Jorma Viikari,

OBJECTIVE: The efficacy of various regimens of initial insulin treatment in poorly controlled type 2 diabetes was compared with regard to diurnal glucose variation. DESIGN: Randomized controlled trial. Setting. Insulin therapy initiated on hospital wards, follow-up as outpatients for 12 months. SUBJECTS: Fifty-two type 2 diabetic patients (HbA1c >7.5%, mean 9.8%) on maximal oral therapy. Interventions. Insulin only (IO), bedtime insulin with sulphonylurea (glipizide) (IS), or bedtime insulin with metformin (IM). MAIN OUTCOME MEASURES: HbA1c and body weight. RESULTS: HbA1c decreased on average by 1.8, 1.0 and 1.5 percentage points in the IO, IS, and IM groups, respectively (p always <0.025). Body weight increased, most in the IO patients (+6.2 kg), least in the IM patients (+3.4 kg). Analysing all treatment groups combined, a similar HbA1c reduction was observed in patients with overall hyperglycaemia (low fasting plasma glucose/HbA1c ratio) and in patients with fasting hyperglycaemia (high fasting plasma glucose/HbA1c ratio). Within the overall hyperglycaemia group, the IS and IM patients had smaller decreases in HbA1c (-1.5 and -1.3 percentage points, respectively) than the IO patients (-2.7 percentage points). On the other hand, within the fasting hyperglycaemia group HbA1c reductions were -1.2, -0.8 and -1.5 percentage points, in the IO, IS, and IM groups, respectively. CONCLUSION: Not all poorly controlled type 2 diabetic patients should automatically be treated with an oral agent and bedtime insulin. Two daily insulin injections is a valid choice, particularly if the patient has overall hyperglycaemia.

Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Publishing Authors By Initials

M ,T ,J Viikari,

For similar persons: age groups: adult: middle aged research abstracts see: persons: age groups: adult: middle aged research

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Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Journal Published:

PUBLICATION TYPE: Randomized Controlled Trial

Journal: Scandinavian journal of primary health care

VOLUME: 25

Page Numbers: 147-53

Journal Abbreviation:

ISSN: 0281-3432

DAY: 26

MONTH: Sep

YEAR: 2007

Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Information

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LANGUAGE: eng

NlmUniqueID: 8510679

Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Keywords Mesh Terms:

KEYWORDS: Middle Aged

MESH TERMS: therapeutic use

Chemical & Substance for Abstract: Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice. Information

Substance Name: Metformin

Registry Number: 657-24-9

Grant and Affiliation Information for Recognition of fasting or overall hyperglycaemia when starting insulin treatment in patients with type 2 diabetes in general practice.

AFFILIATION: City of Turku Health Centre, Turku, Finland. vahatalo@iki.fi

Country: Norway

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MEDLINETA: Scand J Prim Health Care

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