The analysis of factors associated with improved glycemic control in patients with insulin-requiring type 2 diabetes mellitus after treatment.
OBJECTIVE
To observe the effect of standardized ten-day diabetes prevention and control program on glycemic control, and to analyze factors contributing significantly to improvement of glycemic control after the program/intervention.


METHODS
A cross-sectional nested case-control study on 91 adult patients with insulin-requiring type 2 diabetes mellitus who underwent a standardized ten-day diabetes program in the Specialized Hospital "Merkur" in Vrnjačka Banja, Serbia, from June the 1st to August 1st 2010 was performed. All necessary data were obtained from patients' medical files archived in this institution. Cases (n=32) and controls (n=32) were matched for age and sex.


RESULTS
Diabetes program led to a significant decrease in mean daily blood glucose (p=0.039), achieved at the expense of the reduction of postprandial hyperglycemia (p=0.013). Male patients, patients with mean daily glycemia above the acceptable range before the intervention, and patients who were receiving combined therapy (insulin plus oral antidiabetics) before the intervention, were significantly more likely to achieve such positive outcome (ORadjusted = 344.48, 12.83, and 25.44 respectively, with 95%CIs that not included 1).


CONCLUSIONS
Standardized ten-day diabetes educational and rehabilitation program in the Specialized Hospital "Merkur" could be efficient in improving glycemic control, especially for male patients whose glucoregulation was poor despite the combined therapy with insulin and oral antidiabetic agents. Further investigation on determinants of efficiency of this program are necessary to understand better how to facilitate and support improvements in diabetes control at the population level.
Department of Physiology, School of Medical Sciences, University of  Kragujevac, Kragujevac, 2Specialized Hospital "Merkur", Vrnjačka Banja, 3Clinic of Internal Medicine, Center for Endocrinology, Diabetes and Metabolic Diseases, Clinical Centre of  Kragujevac, Kragu- jevac, 4Pediatric Surgery Clinic, Clinical Centre of Kragujevac, Kragujevac, 5Otorynolaryngologic  Clinic, Clinical Centre of Kragujevac, Kragujevac; Serbia.
Predrag
P
Lazarević
Dejan
D
Stanojević
Aleksandar
A
Dukić
Ivan
I
Bubanja
Dragana
D
Bubanja
Violoeta
V
Mladenović
Viktor
V
Krstić
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy* / Q000534:rehabilitation; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D012307:Risk Factors; D055771:Serbia; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin