Simple Insulin Dose Adjustment Using 3-3-1 Algorithm in Japanese Patients with Type 2 Diabetes: Start Kanazawa Study (Self-Titration Aggressive Algorithm with Glargine Trial)

Kyoko Furukawa ,Kiminori Ohyama,Aya Fujimoto,Naoto Yamaaki,Hiroaki Muramoto

doi:10.4236/jdm.2016.63022

Abstract

We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn’t significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose self-adjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.

Highlights

The goal of diabetes treatment is to maintain the comparable glycemic control and QOL with healthy subjects.How to cite this paper: Furukawa, K.D., Yamaaki, N., Fujimoto, A., Ohyama, K. and Muramoto, H. (2016) Simple Insulin Dose Adjustment Using 3-3-1 Algorithm in Japanese Patients with Type 2 Diabetes: Start Kanazawa Study (Self-Titration Aggressive Algorithm with Glargine Trial)
According to 3-3-1 algorithm, both groups were asked to increase the dose of insulin glargine by 1 unit when fasting SMBG exceeded 3 digits (100 mg/dL) in the most recent 3 consecutive days
If hypoglycemia events defined as SMBG less than 70 mg/dL and symptomatic hypoglycemia such as cold sweat occurred, insulin glargine dose was decreased based on the participants or doctors’ decision

Summary

Introduction

The goal of diabetes treatment is to maintain the comparable glycemic control and QOL with healthy subjects.How to cite this paper: Furukawa, K.D., Yamaaki, N., Fujimoto, A., Ohyama, K. and Muramoto, H. (2016) Simple Insulin Dose Adjustment Using 3-3-1 Algorithm in Japanese Patients with Type 2 Diabetes: Start Kanazawa Study (Self-Titration Aggressive Algorithm with Glargine Trial). The goal of diabetes treatment is to maintain the comparable glycemic control and QOL with healthy subjects. In the treatment of type 2 diabetes, it is important to maintain good glucose levels while avoiding hypoglycemia, as well as to manage blood pressure and lipids, in order to prevent progression of complications [1]. It is critical patients are willing to accept diabetes treatment. The study by Ishii, et al has suggested that attaining good glycemic control has helped improve patients QOL and increasing patient motivation for the treatment has contributed improvement of adherence to insulin treatment [2]. In order to continue diabetes treatment, it is considered important that healthcare professionals provide safe and effective medical treatments; patients who are given these treatments proactively accept them with positive attitudes

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Results

Conclusion