Initiation of Basal Insulin in Patients with Uncontrolled Type 2 Diabetes Mellitus

作     者：Muneer Salih Muneer Muneer Salih Muneer

作者机构：Department of Internal Medicine Nile University Khartoum North Sudan 

出 版 物：《Open Journal of Endocrine and Metabolic Diseases》 (内分泌与新陈代谢疾病期刊（英文）)

年 卷 期：2020年第10卷第6期

页      面：89-93页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：T2DM—Type 2 Diabetes Mellitus HbA1c—Haemoglobin A1c% FBG—Fasting Blood Glucose PPG—Post Prandial Glucose NPH—Neutral Protamine Hagedorn 

摘      要：Type 2 diabetes mellitus is a growing health problem, characterized by insulin resistance progressing to beta cell dysfunction and insulin deficiency, most of these patients will need intensification of treatment and initiation of insulin to delay or prevent diabetic complications. Glycemic control is the most important aspect of management, and in reducing morbidity and mortality of the diseases. Control of plasma glucose in patients with diabetes can be assessed by HbA1c, FPG, PPG, but still HbA1c% remains the gold standard for assessment of glycemic control and follow up of diabetic patients. The aim of this study is to assess HbA1c% in patients on oral anti-diabetic drugs, with poor glycemic control before and after adding basal insulin, with titration of the dose of insulin depending on fasting blood sugar. 82 patients with uncontrolled type 2 diabetes (43.9% male, 56.1% female), with HbA1c more than 9%, on two types of oral diabetic medication or more, were started on basal insulin (glargine, lantus) and followed for three to six months. Overall 82 patients with type 2 diabetes mellitus were included in the study. The mean age of the study population was 58.4 years, the mean duration of the disease range was 13.4 years. All patients with HbA1c more than 9%, without organ failure, were included in the study. The mean HbA1c overall had decreased from mean of 11.15% before starting basal insulin to the mean of 8.43% within 3 to 6 month, after initiating basal insulin, this difference was significant at p ve type 2 diabetic patients resulted in significant improvement of glycemic control, with improved HbA1c level,