REAL-WORLD OBSERVATIONAL STUDY REGARDING GLUCOSE CONTROL IN INSULIN TREATED DIABETES MELLITUS PATIENTS. GLUCOSE VARIABILITY PATTERNS ANALYSIS USING CONTINUOUS GLUCOSE MONITORING SYSTEM (CGMS)

In the present study there were evaluated 167 diabetes mellitus patients treated with insulin (without treatment with other oral antidiabetics or other non-insulin injectable antidiabetics) from the Clinical County Hospital of Oradea, Romania in terms of the prescribed insulin therapy (IT) regimen: long-acting (basal) insulin analogues, long-acting insulin analogues and rapidacting (prandial) insulin analogues or premixed insulin and the impact of the IT regimen on the glycaemic control determined by glycosylated haemoglobin (HbA1c). 35.11% of those with basal IT (n = 92), 32.69% of those with basal and prandial IT (n = 52) and 28.57% of those with premixed IT (n = 21) reached a moderate glycaemic control (HbA1c < 7.5%) without any statistically significant differences (p = 0.84). 12 patients were selected by systematic sampling and evaluated for 6 - 8 days by inserting a continuous blood glucose monitoring system (CGMS) in a private practice healthcare office. It was found that in 72% of the monitoring period patients are outside the target glycaemic range of 70 - 150 mg/dL because of hyperglycaemic excursions, in 26% they fell within the therapeutic range and in 2% they were outside the range because of hypoglycaemic excursions. The frequency of hypoglycaemia was high, 50%, but the majority were mild hypoglycaemias and the time spent in hypoglycaemia was extremely short. Therefore modern IT is safe in terms of the risk of hypoglycaemia but glycaemic control is rarely achieved. Hyperglycaemic excursions as demonstrated by CGMS data cannot be explained as hyperglycaemia consecutive to hypoglycaemia.