Frequency of self-adjustment of insulin dose and metabolic control in Type 2 diabetes -is there an association?

Abstract

To investigate the supposition that self-adjustment of insulin dose will improve metabolic control in patients with Type 2 diabetes. The number of self-adjustments of insulin dose was checked in a cross-sectional study involving 300 patients with Type 2 diabetes in a university outpatient department, who were insulin treated. One hundred and ninety-three patients (64%) performed insulin dose adjustments at least once in 14 days. The mean number of dose adjustments was 17.4 per 14 days. Patients with self-adjustments of insulin dose were younger (65.6 vs. 68.9 years), had a higher social status score (11.1 vs. 9.8) and a higher insulin dose (68.8 vs. 53.6 IU/day) than patients without dose adjustments. Each insulin dose adjustment was associated with an HbA(1c) decrease of 0.016% (P = 0.004). Any additional blood glucose self measurement was associated with an HbA(1c) increase of 0.019% (P = 0.038). Two-thirds of patients with Type 2 diabetes, who have undergone training in how to manage their condition, practise insulin dose self-adjustments. A weak association was observed between insulin dose adjustments and HbA(1c).