Glycemic Variability in Patients with Type 2 Diabetes Mellitus: Comparison of Basal and Premixed Insulin Regimens

Wang-Jung Kao ； Wan-Chi Chuang ； Wei-Cheng Chang ； Chia-Fen Wang ； Chih-Hsun Chu

《Formosan Journal of Endocrinology and Metabolism》 9卷2期 (2018/12) Pp. 61-67

https://doi.org/10.6856/FJEM.201812_9(2).0004

摘要

Background. This study aimed to examine whether premixed insulin, compared to basal insulin regimen, could provide superior effects on glycemic variability and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). Methods. This was a cross-sectional study. We recruited 38 ambulatory T2DM patients who received insulin treatments (19 basal, 19 premixed) for at least one year for the present study. To be included in this study, the patients had to be 20‑80 years old. Their glycated hemoglobin A_(1c) (A1C) levels should be in the range of 6.5% and 10.0%. The exclusion criteria were type 1 diabetes, gestational diabetes, and any other specific type of diabetes. Biochemistry, continuous glucose monitoring, and common carotid ultrasound for CIMT were performed in all subjects. Results. The patients with basal insulin regimen took more oral antidiabetic drugs than those with premixed insulin. The total daily insulin doses used in the basal insulin group were 25 ± 16 units and were 70 ± 45 units in the premixed insulin group, respectively. There were no significant differences in A1C values and parameters of glucose variability between the two groups. Both groups had similar values of mean CIMT. Only age, but not insulin regimens, was associated with mean CIMT in multivariate linear regression analyses. Conclusion. We demonstrated that treatment with premixed insulin had similar effects on glucose variability and CIMT compared with basal insulin regimen in ambulatory patients with T2DM.

關鍵字

type 2 diabetes ； insulin ； blood glucose ； carotid intima-media thickness