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Assessment of basal insulin requirement using fasting tests in insulin-treated patients with type 2 diabetes mellitus.
Wiesli, P; Lehmann, R; Krayenbuehl, P-A; Schmid, C; Spinas, G A.
Afiliação
  • Wiesli P; Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, Zurich, Switzerland. peter.wiesli@stgag.ch
Exp Clin Endocrinol Diabetes ; 114(10): 539-43, 2006 Nov.
Article em En | MEDLINE | ID: mdl-17177134
ABSTRACT

AIMS:

Characterizing the time course of the rise of blood glucose concentrations in the fasting state during the day and night in patients with type 2 diabetes.

METHODS:

40 consecutive insulin-treated patients with type 2 diabetes underwent fasting tests on two different days with either no breakfast and lunch (fasting time of 20 hours) or no dinner (fasting time of 21 hours). Glucose-lowering medication was stopped prior to the test according to the half-life of the medication prescribed. At the start of the fasting tests, blood glucose concentrations were lowered to below 7 mmol/L using an insulin infusion.

RESULTS:

26 men and 14 women were included in the study. Mean (+/-SD) age was 61+/-10 years, BMI 31+/-7 kg/m (2), and HbA1c 7.5+/-1%. Diabetes duration was 14+/-8 years and duration of insulin therapy had been prescribed for a mean of 6+/-6 years. During the daytime fast, plasma glucose concentrations rose by a mean of 0.8+/-1.6 mmol/L. During the nighttime fast, plasma glucose concentrations increased particularly after midnight, by 4.3+/-2.1 mmol/L, i.e. significantly more than during the daytime fast.

CONCLUSIONS:

Fasting blood glucose concentrations in the majority of insulin-treated patients with type 2 diabetes increase markedly after midnight. No similar increase is observed during the day. Thus, for most patients with type 2 diabetes, an intermediate- or long-acting insulin injected at bedtime with a peak action six to eight hours after injection should be appropriate.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Diabetes Mellitus Tipo 2 / Insulina Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Exp Clin Endocrinol Diabetes Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Suíça
Buscar no Google
Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Glicemia / Diabetes Mellitus Tipo 2 / Insulina Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Exp Clin Endocrinol Diabetes Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2006 Tipo de documento: Article País de afiliação: Suíça