title: Multiple insulin injection therapy using an insulin pen--who benefits? A clinical 3-year follow-up study of 100 type 1 and 51 type 2 diabetic patients.
abstract: The present study was undertaken with the aim of evaluating the effect of multiple insulin injection therapy with an insulin pen in a large population of type 1 and type 2 diabetes patients and to investigate which factors predict a favorable response to the therapy change. We included 100 type 1 and 51 type 2 patients with a minimum diabetes duration of 1 year who were followed for at least 3 years after changing from conventional insulin regimens to multiple insulin injection therapy with the pen. Both type 1 and type 2 patients were significantly improved with respect to metabolic control at 3 months. After 1 year type 1 patients were no longer significantly improved compared to baseline. In type 2 patients a significant improvement was sustained for a longer period but at 3 years HbA1c had reverted towards the baseline level. Both type 1 and type 2 patients experienced a significant increase in body weight. Baseline metabolic control was strongly and inversely related to subsequent decline in HbA1c in both type 1 and type 2 patients. Those with initial poor control had a sustained improvement throughout follow-up, whereas those with initial very good control deteriorated significantly. No sustained change was noted in those in intermediate control. In addition, in type 1 patients a high body mass index at baseline was a weak negative predictor for improvement. In type 2 patients a longer duration of diabetes was a favorable factor. Both type 1 and 2 patients in poor control may be expected to benefit from multiple injection therapy.
authors.affiliation: Department of Internal Medicine, Ostra sjukhuset, Göteborg, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Rosengren
authors.forename: A
authors.initials: A
authors.lastname: Adlerberth
authors.forename: L E
authors.initials: LE
authors.lastname: Bresäter
authors.forename: S
authors.initials: S
authors.lastname: Ehnberg
authors.forename: L
authors.initials: L
authors.lastname: Welin
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007279:Injections, Subcutaneous / Q000295:instrumentation; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin