title: [Insulin regimes and impact on glycemic control in patients with type 1 diabetes].
abstract: Objective:To describe the insulin regimens and their associations with glycemic control and to explore factors associated with intensive insulin therapy.Methods:Patients with type 1 diabetes (T1DM) were recruited from Guangdong Type 1 Diabetes Mellitus Translational Medicine Study which was conducted in 16 centers in Guangdong province. The demographic and clinical data were collected. Patients were grouped according to different insulin regimens: insulin pump (R1), basal insulin plus regular insulin or short-acting insulin (R2), insulin injection 1-3 times per day (R3). Distribution of insulin regimens and the relationships between insulin regimens and hemoglobin A1c (HbA1c) were described. Multivariate logistic regression was used to identify factors associated with intensive insulin therapy.Results:A total of 1 421 patients with the age of 27.8 (19.4, 38.3) years and a duration of T1DM of 3.3 (0.5, 7.1) years were recruited. There was 12.3% of patients in R1 (n=175), 35.5% in R2 (n=504), and 52.2% in R3 (n=742), respectively. HbA1c was 8.0 (6.8, 9.3)%, 8.9 (7.1, 11.8)%, and 9.2 (7.5, 11.4)% in R1, R2, R3, respectively, and it was associated with insulin regimens (P<0.001). HbA1c target rate was 32.3%, 21.1%, 17.8% in R1, R2, R3, respectively (P=0.002). Older age (OR=1.01,P=0.027), higher education level (college or above) (OR=1.56,P=0.003), and higher household income (>30 000 yuan per year per person)(OR=1.45,P=0.009) were associated with intensive insulin therapy in adult patients.Conclusions:The study suggested that insulin therapy need to be optimized in patients with T1DM. The optimization of insulin regimens and diabetes education may be helpful for improvement of glycemic control.
authors.affiliation: Department of Endocrinology and Metabolic Disease, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou 510630, China.
authors.forename: J H
authors.initials: JH
authors.lastname: Yan
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: X Y
authors.initials: XY
authors.lastname: Zheng
authors.forename: S H
authors.initials: SH
authors.lastname: Luo
authors.forename: H Y
authors.initials: HY
authors.lastname: Ai
authors.forename: J
authors.initials: J
authors.lastname: Lü
authors.forename: L L
authors.initials: LL
authors.lastname: Qiu
authors.forename: X W
authors.initials: XW
authors.lastname: Zhang
authors.forename: D Z
authors.initials: DZ
authors.lastname: Yang
authors.forename: B
authors.initials: B
authors.lastname: Yao
authors.forename: J P
authors.initials: JP
authors.lastname: Weng
mesh_terms: D000328:Adult; D001786:Blood Glucose; D003922:Diabetes Mellitus, Type 1; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents; D007328:Insulin; D007332:Insulin Infusion Systems; D016015:Logistic Models; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Diabetes, type 1; Hemoglobin A, glycosylated; Insulin