Adequate Structured Inpatient Diabetes Intervention in People With Type 1 Diabetes Improves Metabolic Control and Frequency of Hypoglycaemia.
Exp Clin Endocrinol Diabetes
; 128(12): 796-803, 2020 Dec.
Article
en En
| MEDLINE
| ID: mdl-31091546
ABSTRACT
OBJECTIVE:
Several studies evaluated inpatient diabetes teaching and treatment programmes (DTTP) in diabetes type 1 (DM1) many years ago, but in these studies insulin treatment was not yet intensified before the DTTP. Today, most patients are already on intensified insulin treatment before entering a DTTP. The aim of this trial was to evaluate the outcome one year after participation in an inpatient intervention including a DTTP in a longitudinal study.METHODS:
109 patients participated in an inpatient intervention in 2014. All individuals were invited to participate in an outpatient follow-up visit after one year.RESULTS:
Ninety participants (52.2% female, age 48.0 y, diabetes duration 19.1 y, 31.1% CSII, HbA1c 7.9%â/â63.3 mmol/mol) were followed-up after 1.2±0.3 y [1 died, 18 declinedâ/âwere not available]. 83â/â90 individuals participated to optimise diabetes therapy, 7â/â90 had newly-diagnosed DM1. In the optimisation group, HbA1c decreased by 0.4% (p=0.009) without change of insulin dose (54 IU/day before and after) or BMI (26 kg/m2 before and after). In people with baseline HbA1c ≥7.5% (n=26â/â83), HbA1c decreased by 0.9%. The frequency of severe hypoglycaemia decreased from 0.22 to 0.05 eventsâ/âyear (p=0.045). In people with frequent non severe hypoglycaemia (n=8), events decreased from 4.5±2.0 to 2.8±0.9â/âweek (p=0.358). Systolic (-6.5 mmHg, p=0.035) and diastolic (-3.4 mmHg, p=0.003) blood pressure improved without change of number of antihypertensive medication (1.9±2.1 vs. 1.8±2.0, p=0.288).CONCLUSIONS:
In people with DM1, metabolic control improved after the inpatient intervention without increasing insulin dosage or BMI. The inpatient intervention remains effective to substantially improve metabolic control under the present circumstances of care.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Educación del Paciente como Asunto
/
Diabetes Mellitus Tipo 1
/
Hipoglucemia
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Hipoglucemiantes
/
Insulina
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Exp Clin Endocrinol Diabetes
Asunto de la revista:
ENDOCRINOLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Alemania