The basal to total insulin ratio in outpatients with diabetes on basal-bolus regimen

被引：7

作者：

Castellano E. ^{[1
]}

Attanasio R. ^{[2
]}

Giagulli V.A. ^{[3
]}

Boriano A. ^{[4
]}

Terzolo M. ^{[5
]}

Papini E. ^{[6
]}

Guastamacchia E. ^{[7
]}

Monti S. ^{[8
]}

Aglialoro A. ^{[9
]}

Agrimi D. ^{[10
]}

Ansaldi E. ^{[11
]}

Babini A.C. ^{[12
]}

Blatto A. ^{[13
]}

Brancato D. ^{[14
]}

Casile C. ^{[15
]}

Cassibba S. ^{[16
]}

Crescenti C. ^{[17
]}

De Feo M.L. ^{[18
]}

Del Prete A. ^{[19
]}

Disoteo O. ^{[20
]}

Ermetici F. ^{[21
]}

Fiore V. ^{[22
]}

Fusco A. ^{[23
]}

Gioia D. ^{[24
]}

Grassi A. ^{[25
]}

Gullo D. ^{[26
]}

Lo Pomo F. ^{[27
]}

Miceli A. ^{[15
]}

Nizzoli M. ^{[28
]}

Pellegrino M. ^{[1
]}

Pirali B. ^{[29
]}

Santini C. ^{[30
]}

Settembrini S. ^{[31
]}

Tortato E. ^{[32
]}

Triggiani V. ^{[7
]}

Vacirca A. ^{[33
]}

Borretta G. ^{[1
]}

机构：

[1] Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Via Michele Coppino 26, Cuneo

[2] Endocrinology Service, Galeazzi Institute, IRCCS, Milan

[3] Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, Conversano

[4] Medical Physics Department, Santa Croce and Carle Hospital, Cuneo

[5] Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Hospital, Orbassano

[6] Department of Endocrinology and Metabolism, Regina Apostolorum Hospital, Albano Laziale

[7] Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, Bari

[8] Endocrinology, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Rome

[9] Metabolism and Diabetes Unit, San Martino Hospital, Genoa

[10] District Hospital, Azienda Sanitaria Locale, Brindisi

[11] Department of Endocrinology and Diabetes, Santissimi Antonio e Biagio Hospital, Alessandria

[12] Medical Division, Rimini Hospital, Rimini

[13] Department of Endocrinology, Maria Vittoria Hospital, Torino

[14] Department of Internal Medicine and Diabetology, Hospital of Partinico, Partinico

[15] Internal Medicine Department, Papardo Hospital, Messina

[16] Endocrinology and Diabetes, Papa Giovanni XXIII Hospital, Bergamo

[17] Department of Endocrinology and Diabetes, San Giovanni di Dio Hospital, Florence

[18] Endocrinology Unit, Careggi Hospital, Florence

[19] Outpatient Clinic for Diabetes, Azienda Sanitaria Locale, Civita Castellana

[20] Diabetology Department, Niguarda Hospital, Milan

[21] Endocrinology and Metabolism, IRCCS Policlinico San Donato, San Donato Milanese

[22] Angelucci Hospital, Subiaco

[23] Antidiabetic Center AID, Garibaldi Hospital, Naples

[24] Department of Endocrinology, Villa Sofia Hospital, Palermo

[25] Division of Endocrinology, Mauriziano Umberto I Hospital, Torino

[26] Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Medical Center, Catania

[27] Division of Endocrinology, San Carlo Hospital, Potenza

[28] Department of Endocrinology, Morgagni Hospital, Forlì

[29] Unit of Internal Medicine, Humanitas Mater Domini, Castellanza

[30] Department of Endocrinology and Diabetology, Bufalini Hospital, Cesena

[31] Diabetology Service, Azienda Sanitaria Locale Na 1, Naples

[32] Diabetology Service, Augusto Murri Hospital, Fermo

[33] Department of Internal Medicine, Imola Hospital, Imola

来源：

Journal of Diabetes & Metabolic Disorders | 2018年 / 17卷 / 2期

关键词：

Basal bolus; Hypoglycemia; Insulin therapy; Type; 1; diabetes; 2;

D O I：

10.1007/s40200-018-0358-2

中图分类号：

学科分类号：

摘要：

Objective: To evaluate the basal/total ratio of daily insulin dose (b/T) in outpatients with diabetes type 1 (DM1) and type 2 (DM2) on basal-bolus regimen, by investigating whether there is a relationship with HbA1c and episodes of hypoglycemia. Methods: Multicentric, observational, cross-sectional study in Italy. Adult DM1 (n = 476) and DM2 (n = 541) outpatients, with eGFR >30 mL/min/1.73 m2, on a basal-bolus regimen for at least six months, were recruited from 31 Italian Diabetes services between March and September 2016. Clinicaltrials.govID: NCT03489031. Results: Total daily insulin dose was significantly higher in DM2 patients (52.3 ± 22.5 vs. 46 ± 20.9 U/day), but this difference disappeared when insulin doses were normalized for body weight. The b/T ratio was lower than 0.50 in both groups: 0.46 ± 0.14 in DM1 and 0.43 ± 0.15 in DM2 patients (p = 0.0011). The b/T was significantly higher in the patients taking metformin in both groups, and significantly different according to the type of basal insulin (Degludec, 0.48 in DM1 and 0.44 in DM2; Glargine, 0.44 in DM1 and 0.43 in DM2; Detemir, 0.45 in DM1 and 0.39 in DM2). The b/T ratio was not correlated in either group to HbA1c or incidence of hypoglycemia (<40 mg/dL, or requiring caregiver intervention, in the last three months). In the multivariate analysis, metformin use and age were independent predictors of the b/T ratio in both DM1 and DM2 patients, while the type of basal insulin was an independent predictor only in DM1. Conclusion: The b/T ratio was independent of glycemic control and incidence of hypoglycemia. © 2019, The Author(s).

引用

页码：393 / 399

页数：6

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