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Comparative Effects of Two Different Multiple Injection Regimens on Blood Glucose Control and Patient Acceptance in Type 1 Diabetes
Author(s) -
Wolffenbuttel B.H.R.,
Ouwerkerk B.M.,
Veldhuyzen B.F.E.,
GeelhoedDuijvestijn P.H.L.M.,
Jakobsen G.,
Doorn L.G.
Publication year - 1990
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1990.tb01472.x
Subject(s) - medicine , bedtime , evening , regimen , insulin , morning , diabetes mellitus , nph insulin , basal (medicine) , type 2 diabetes , endocrinology , hypoglycemia , insulin glargine , physics , astronomy
In a randomized cross‐over study we compared blood glucose control and patient acceptance of a 12‐week basal‐prandial regimen with short‐acting insulin before meals and isophane (NPH) insulin at bedtime (4 injections) with a scheme with a second injection of isophane (NPH) insulin before breakfast (5 injections). Forty‐three Type 1 diabetic patients (age 37 ± 11 (± SD) years, duration of diabetes 15 (range 2–48) years, 26 males and 17 females) completed the study. Mean daily blood glucose was 8.6 ± 2.4 mmol I −1 at baseline, and 8.1 ± 2.2 mmol I −1 after the four‐injection period and 7.9 ± 2.0 mmol I −1 with five‐injections (NS). HbA 1c after 12 weeks was not different with the two treatments (6.6 ± 1.1 vs 6.5 ± 0.9%), neither was fasting blood glucose (9.6 ± 4.2 mmol I 1c with 4 injections, and 9.0 ± 4.4 mmol I −1 with 5 injections). Daily insulin dose did not differ between regimens (55 vs 56 U day −1 ). No differences in number or severity of hypoglycaemic events were observed. After the study, 13 patients preferred to continue the 5‐injection regimen, and 21 patients preferred 4 injections. Treatment satisfaction with either regimen was equally high. It is concluded that dividing the intermediate‐acting insulin into a morning and an evening dose did not lead to an improvement in blood glucose control in these moderately‐controlled Type 1 diabetic patients.