title: [Medium-term results of a Day Hospital insulin therapy program for patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  The profile of the patient with type 2 diabetes mellitus (DM2) who requires insulin therapy is very diverse as are the results of this intervention and short/middle-term patient management. We evaluated the midterm results of an outpatient program starting insulin therapy with≥2 insulin injections/day in terms of metabolic control in different groups of patients.
  
  
  METHODS
  We analyzed prospectively 131 patients with DM2, without previous insulin treatment, who were prescribed treatment with≥2 insulin injections/day and who were enrolled in a specific ambulatory program in order to start insulin therapy in a Day Hospital for 6 months.
  
  
  RESULTS
  The initial glycosylated hemoglobin (HbA1c) was 11.3 (2.3) % and decreased to 6.3 (1.4) % in 6 months, with HbA1c<7% in 72.5% of them. The group of recently diagnosed patients (<3 months, symptomatic severe hyperglycemia, D-group) were younger (57.1 [10.8] vs 64.2 [12.1] years; P<.01) and had a higher starting HbA1c (12.1 [1.8] vs 10.5 [2.5] %; P<.001) than patients included in the program for oral antidiabetic drugs' failure (F-group). At the end of the program 50% of D-group patients did not need insulin (6.3% on F-group [P<.001]). There were no significant differences in either of 2 groups at study ends according to the final treatment scheme.
  
  
  CONCLUSIONS
  Counselling patients with DM2 to start insulin with more than one injection per day in Day Hospital setting achieves and maintains a good metabolic control in the medium term in different patient profiles. Among symptomatic and recently diagnosed patients, insulin therapy can be stopped in 50% of them at the medium term.
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España. Electronic address: cmquiros@clinic.ub.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Quirós
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Amor
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Ana M
authors.initials: AM
authors.lastname: de Hollanda
authors.affiliation: Hospital de Día del Institut de Malalties Digestives i Metabòliques, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Yago
authors.affiliation: Hospital de Día del Institut de Malalties Digestives i Metabòliques, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Ara
authors.affiliation: Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Conget
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001835:Body Weight; D003631:Day Care, Medical; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Diabetes tipo 2; Insulin therapy; Insulinoterapia; Mal control metabólico; Outpatient; Paciente ambulatorio; Poor metabolic control; Type 2 diabetes