Abstract
Without sufficient insulin treatment, acceptable level of glycoregulation, avoidance of dislipoproteinaemia and maintenance of body mass is difficult to achieve in patients with type 1 diabetes mellitus (DM). On the other hand sometimes it is difficult to prevent weight gain, endogenous hyperlipidemia and iatrogenic insulin resistance. To compare metabolic control indicators in patients with type 1 DM in patients treated conventionally to those on intensified insulin regimen. A sample of 52 persons with type 1 DM, without late complications and long duration of the disease, was selected. Among them 19 (36.5%) persons were treated with insulin in 4 or 5 doses, and 33 (63.5%) conventionally, in 2 doses. All the participants had biochemical indicators of metabolic control determined (glycosylated Hb , fasting and postprandial glycaemia, total cholesterol, triglycerides as well as lipoprotein fractions, HDLC and LDLC), body height (BH) and weight (BW) measured, body mass index calculated (BMI) and blood pressure measured (BP). In the group treated conventionally we found significantly higher mean values of BMI as compared to those on intensified insulin treatment (23.2 +/- 2.0 kg/m2, and 21.2 +/- 1.2 kg/m2 respectively, p%<0.01) and proportion of those with overweight was as well significantly higher (27.3% versus 0%, p =0.012). We noted higher mean values of systolic (134.2 +/- 17.6 mmHg, versus 123.4 +/- 12.7. p<0.05) and diastolic (83.2 +/- 10.1, versus 74.0 +/- 9.7, p<0.01) BP. Biohemical indicators of glycoregulation were significantly worse with, at the same time, higher total dose of applied insulin ( 55.9 +/- 8.5 IU, versus 46.3 +/- 10.0 IU, p<0.01), and insulin units per kg of body weight (0.84 +/- 0.11 IU/kg versus 0.77 +/- 0.15 IU/kg, p<0.05). Results indicate that intensified insulin treatment is more favourable variant of treatment, by which the certain level of insulin resistance, which might be present in patients treated with two higher insulin doses, is probably reduced. Therefore it improves metabolic outputs, blood pressure values and body mass index but also may have beneficial impact to economic aspect of insulin treatment as well.
Highlights
Without sufficient insulin treatment, acceptable level of glycoregulation, avoidance of dislipoproteinaemia and maintaince of body mass is difficult to achieve in patients with type 1 diabetes mellitus (DM)
A sample of 52 persons with type 1 diabetes mellitus, with similar age and relatively short duration of the disease, who were treated on outpatient basis at the Department of Diabetes and Endocrinology of Clinical Centre University of Sarajevo, was selected
Nutritional status was assessed by measuring body weight (BW) and body height (BH) and calculating the body mass index (BMI) [/weight/height (m2)/] with a body mass index calculated (BMI) of less than 18.5 indicating undernourishment and higher than 25 indicating being overweight
Summary
Acceptable level of glycoregulation, avoidance of dislipoproteinaemia and maintaince of body mass is difficult to achieve in patients with type 1 diabetes mellitus (DM). Conclusion: Results indicate that intensified insulin treatment is more favourable variant of treatment, by which the certain level of insulin resistance, which might be present in patients treated with two higher insulin doses, is probably reduced. It improves metabolic outputs, blood pressure values and body mass index and may have beneficial impact to economic aspect of insulin treatment as well. The main aim of this cross-sectional study is to compare metabolic control and nutritional indicators in patients with type 1 diabetes mellitus treated conventionally to those on intensified insulin regimen
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