title: Are we helping or harming our insulin-treated diabetic patients during ambulatory treatment?
abstract: BACKGROUND
  Correctness of insulin treatment depends on both the experience and skills of the doctor and knowledge and behaviour of the patient.
  
  
  OBJECTIVE
  Evaluation the adequacy of insulin doses administered to diabetes patients in ambulatory conditions.
  
  
  METHODS
  The treatment of 59 patients hospitalized in the Diabetology Ward was evaluated at admission, discharge and 3 months after hospitalization.
  
  
  RESULTS
  The mean daily doses of insulin significantly differed at times of evaluation and were: 53.90, 39.31 and 43.34 units, respectively (p≈0.000001). A significant reduction of body weight, 90.86 vs. 88.25 kg (p≈0.000001), was obtained only during hospitalization, and was maintained 3 months after discharge (87.86 kg). Significant differences were also noted in the body mass index (33.44 vs. 32.48 vs. 32.37 kg/m(2), p≈0.000001). The change in waist circumference was not statistically significant (107.87 vs. 104.89 cm; p≈0.06). A decrease in the number of hypoglycaemia episodes was observed, but were statistically insignificant (25 vs. 23; p≈0.7). Three months after hospitalization an insignificant decrease of HbA1c level was noted (8.41% vs. 8.03%; p≈0.07).
  
  
  CONCLUSIONS
  During treatment in the Diabetology Ward the procedure of choice was more frequently a reduction than an increase in insulin doses. This management led to the reduction of the patients' body weight, improvement of glycaemia, without any significant effect on the diabetes control determined by the HbA1c level.
authors.affiliation: Diabetology Ward, Institute of Rural Health, Lublin, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Szcześniak
authors.forename: Piotr
authors.initials: P
authors.lastname: Dziemidok
authors.forename: Piotr S
authors.initials: PS
authors.lastname: Paprzycki
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D013997:Time Factors; D015431:Weight Loss; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin