TY - JOUR
T1 - Insulin requirement profiles of patients with type 2 diabetes after achieving stabilized glycemic control with short-term continuous subcutaneous insulin infusion
AU - Noh, Yun Hee
AU - Lee, Won Jin
AU - Kim, Kyoung Ah
AU - Lim, Inja
AU - Lee, Jun Ho
AU - Lee, Ju Han
AU - Kim, Seonguk
AU - Choi, Soo Bong
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Background: As in type 1 diabetes, continuous subcutaneous insulin infusion (CSII) therapy is emerging as a promising therapeutic option in type 2 diabetes. However, the insulin requirement profiles of patients with type 2 diabetes when treated via CSII with rapid-acting insulin analogs have not been well investigated. Methods: We examined insulin requirement profiles of type 2 diabetes patients (n=300; age, 57.9±11.4 years; hemoglobin A1c [HbA 1c], 9.1±2.2%) for 3 days after achieving normoglycemia via 1-2 weeks of CSII therapy. We also analyzed the total daily dose (TDD) of insulin-associated clinical and laboratory parameters at baseline. Results: The mean TDD was 45.1±24.7IU/day (range, 4.8-145.8IU/day). The total daily bolus (TBo) (range 2.8-111.3IU/day) was 64.1±12.1% of the TDD. The rates of infusion for day and night in total daily basal dose (TBa) were 0.74±0.35 and 0.41±0.32IU/h, respectively. The dose ratio (in IU/day) was 2.7:1.9:1.6:1.8:1 (breakfast, lunch, and dinner bolus and day and night basal, respectively). After adjusting for age, gender, and body mass index, TDD was associated with HbA1c, fasting and 2-h postprandial plasma glucose, fasting C-peptide, and carbohydrate-to-insulin ratio (P<0.05). Conclusions: Initial TDD in type 2 diabetes patients on CSII showed a wide range of distribution with a TBo-to-TBa ratio >2.0 and was associated with parameters indicating glycemic control but not with body weight, suggesting that the currently used protocol in dose determination of insulin, including allocation of half of the TDD to TBa or weight-based determination of initial TDD, may need to be reexamined when treating type 2 diabetes with CSII therapy.
AB - Background: As in type 1 diabetes, continuous subcutaneous insulin infusion (CSII) therapy is emerging as a promising therapeutic option in type 2 diabetes. However, the insulin requirement profiles of patients with type 2 diabetes when treated via CSII with rapid-acting insulin analogs have not been well investigated. Methods: We examined insulin requirement profiles of type 2 diabetes patients (n=300; age, 57.9±11.4 years; hemoglobin A1c [HbA 1c], 9.1±2.2%) for 3 days after achieving normoglycemia via 1-2 weeks of CSII therapy. We also analyzed the total daily dose (TDD) of insulin-associated clinical and laboratory parameters at baseline. Results: The mean TDD was 45.1±24.7IU/day (range, 4.8-145.8IU/day). The total daily bolus (TBo) (range 2.8-111.3IU/day) was 64.1±12.1% of the TDD. The rates of infusion for day and night in total daily basal dose (TBa) were 0.74±0.35 and 0.41±0.32IU/h, respectively. The dose ratio (in IU/day) was 2.7:1.9:1.6:1.8:1 (breakfast, lunch, and dinner bolus and day and night basal, respectively). After adjusting for age, gender, and body mass index, TDD was associated with HbA1c, fasting and 2-h postprandial plasma glucose, fasting C-peptide, and carbohydrate-to-insulin ratio (P<0.05). Conclusions: Initial TDD in type 2 diabetes patients on CSII showed a wide range of distribution with a TBo-to-TBa ratio >2.0 and was associated with parameters indicating glycemic control but not with body weight, suggesting that the currently used protocol in dose determination of insulin, including allocation of half of the TDD to TBa or weight-based determination of initial TDD, may need to be reexamined when treating type 2 diabetes with CSII therapy.
UR - http://www.scopus.com/inward/record.url?scp=77949409018&partnerID=8YFLogxK
U2 - 10.1089/dia.2009.0131
DO - 10.1089/dia.2009.0131
M3 - Article
C2 - 20210565
AN - SCOPUS:77949409018
SN - 1520-9156
VL - 12
SP - 271
EP - 281
JO - Diabetes Technology and Therapeutics
JF - Diabetes Technology and Therapeutics
IS - 4
ER -