The basal to total insulin ratio in outpatients with diabetes on basal-bolus regimen View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-12

AUTHORS

Elena Castellano, R. Attanasio, V. A. Giagulli, A. Boriano, M. Terzolo, E. Papini, E. Guastamacchia, S. Monti, A. Aglialoro, D. Agrimi, E. Ansaldi, A. C. Babini, A. Blatto, D. Brancato, C. Casile, S. Cassibba, C. Crescenti, M. L. De Feo, A. Del Prete, O. Disoteo, F. Ermetici, V. Fiore, A. Fusco, D. Gioia, A. Grassi, D. Gullo, F. Lo Pomo, A. Miceli, M. Nizzoli, M. Pellegrino, B. Pirali, C. Santini, S. Settembrini, E. Tortato, V. Triggiani, A. Vacirca, G. Borretta, all on behalf of Associazione Medici Endocrinologi (AME)

ABSTRACT

Objective: To evaluate the basal/total ratio of daily insulin dose (b/T) in outpatients with diabetes type 1 (DM1) and type 2 (DM2) on basal-bolus regimen, by investigating whether there is a relationship with HbA1c and episodes of hypoglycemia. Methods: Multicentric, observational, cross-sectional study in Italy. Adult DM1 (n = 476) and DM2 (n = 541) outpatients, with eGFR >30 mL/min/1.73 m2, on a basal-bolus regimen for at least six months, were recruited from 31 Italian Diabetes services between March and September 2016. Clinicaltrials.govID: NCT03489031. Results: Total daily insulin dose was significantly higher in DM2 patients (52.3 ± 22.5 vs. 46 ± 20.9 U/day), but this difference disappeared when insulin doses were normalized for body weight. The b/T ratio was lower than 0.50 in both groups: 0.46 ± 0.14 in DM1 and 0.43 ± 0.15 in DM2 patients (p = 0.0011). The b/T was significantly higher in the patients taking metformin in both groups, and significantly different according to the type of basal insulin (Degludec, 0.48 in DM1 and 0.44 in DM2; Glargine, 0.44 in DM1 and 0.43 in DM2; Detemir, 0.45 in DM1 and 0.39 in DM2). The b/T ratio was not correlated in either group to HbA1c or incidence of hypoglycemia (<40 mg/dL, or requiring caregiver intervention, in the last three months). In the multivariate analysis, metformin use and age were independent predictors of the b/T ratio in both DM1 and DM2 patients, while the type of basal insulin was an independent predictor only in DM1. Conclusion: The b/T ratio was independent of glycemic control and incidence of hypoglycemia. More... »

PAGES

393-399

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40200-018-0358-2

DOI

http://dx.doi.org/10.1007/s40200-018-0358-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107348290

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30918874


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