title: Thrice-weekly insulin injection with nurse's support for diabetic hemodialysis patients having difficulty with self injection.
abstract: Although poor glycemic control is known as an independent predictor of mortality in diabetic hemodialysis patients, it is often difficult for some patients to perform standard self injection insulin therapy. Some practical methods are needed for such patients. We evaluated the usefulness of a new regimen of insulin therapy, namely thrice-weekly insulin injection with nurse's support (TWINS) using insulin NPH or glargine at the end of each hemodialysis sessions in 5 outpatients on hemodialysis with type 2 diabetes mellitus showing HbAlc levels > or = 8.0% (JDS). HbA1c levels were successfully decreased in all patients from 9.3 +/- 1.1% to 6.9 +/- 0.7% (mean +/- SD) in six months without hypoglycemia symptoms. These preliminary results suggest that this regimen can be one of the practical choices in poor-controlled diabetes patients on regular hemodialysis who have difficulty in self injection of insulin.
authors.affiliation: Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University, Graduate School of Medicine, Japan. t-shoji@med.osaka-cu.ac.jp
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shoji
authors.forename: Masanori
authors.initials: M
authors.lastname: Emoto
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Mori
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Morioka
authors.forename: Shinya
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Tatsuji
authors.initials: T
authors.lastname: Takahashi
authors.forename: Akihide
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000628:therapy*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D009726:Nurses; D006435:Renal Dialysis; D012646:Self Administration
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human