Endocrine Abstracts

Objectives: To verify the results of the insulin treatment intensification in the control of Diabetes Mellitus type 1 and 2 (DM1 and DM2).

Methodology: Of 100 diabetic patients (30% DM1 and 70%DM2) derived to Day Diabetes Hospital (DDH) by glycemic decompensation during year 2007 were studied, 45% women and 55% men (we excluded the debut). The average age of the patients was of 35.1 years in DM1 and 64.4 years in DM2. The Hba1c in the first visit and to the 3 months was analyzed, as well as weight, dose of insulin, glycemic average and glycemic variability. The treatment intensification consisted of modifying the insulin guidelines (from mixtures to bolus-basal in DM1; from basal to mixtures, from 2 to 3 mixtures and mixtures to bolus-basal in DM2) and re-education. In this period of time there were an average of 3.06 revisions by patient.

Results: In DM1: the HbA1c happened from 10.2±2.3% ** to 8.3±1.6% **; the initial average weight was of 66 kg and the end of 67.6 kg; the initial insulin metering was of 0.78±0.3 UI/kg and the ending of 0.86±0.3 UI/kg; glycemic average evolved from 213 to 167 mg/dl and the glycemic variability average happened from 86 to 80.3 mg/dl.

In DM2: the HbA1c happened from 9.9±1.9% ** to 7.9±1.3% **; the initial average weight was of 80.6 kg and the end of 81 kg; the initial insulin metering was of 0.78±0.4 UI/kg and the ending of 1.37±0.9 UI/kg; glycemic average evolved from 243.6 to 174.1 mg/dl and the glycemic variability average happened from 72.9 to 59.6 mg/dl.

Conclusions: • DDH has demonstrated to be a useful device to improve the metabolic control of the patients, improving the HbA1c, glycemic average and glycemic variability as much in DM1 as in DM2

• Reduction of HbA1c levels was greater in those patients whose initial HbA1c was higher.