[Is intensive functional insulin therapy the method of choice in newly diagnosed type-1 diabetes mellitus?].
The aim of our study was a prospective evaluation of type 1 diabetic patients treated with intensive insulin therapy. We recruited 100 patients (62 males and 38 females) aged 24.3+/-6.2 years with newly diagnosed type 1 diabetes. The mean observation period was 5.2+/-1.5 years. Parameters of diabetes metabolic balance, occurrence of chronic complications and patients' knowledge about the disease and the methods of its treatment were evaluated. 68% of the patients controlled their glycaemia regularly before main meals and 53% of them had a diabetic diary. In the knowledge test 20% of the subjects reached < or = 11 points, 62% 11-17 points and 18% > 17 points (mean 14.4+/-3.2 points of maximal 20 to achieve). The mean result in the questionnaire of knowledge about the disease was 28.1+/-4.9 points. Fasting glycaemia was 7.2+/-3.4 mmol/l, 2h postprandial glycaemia 9.4+/-3.6 mmol/l, HbA1c 7.5+/-1.4%, the mean C-peptide level 0.9+/-0.4 ng/ml and the number of hypoglycaemic episodes was 6/individual/month. We observed a statistically significant correlation between the level of patients' knowledge and HbA1c (r=-0.31, p<0.05). Retinopathy and nephropathy were detected in 8 (9%) and 6 (6.8%) subjects respectively. The risk of microangiopathy was connected with low knowledge (RR: 5.67; 95% CI: 2.02-15.82, p<0.0002). The study confirms the crucial role of intensive insulin therapy and systematic patients' education concerning the disease in maintaining a good metabolic control and thus reducing the risk of diabetic vascular complications.
Araszkiewicz
Aleksandra
A
Klinika Chorób Wewnetrznych i Diabetologii AM w Poznaniu.
Zozulińska
Dorota
D
Trepińska
Magdalena
M
Wierusz-Wysocka
Bogna
B
D000328:Adult; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D007328:Insulin