PMID- 27321332
OWN - NLM
STAT- MEDLINE
DCOM- 20161215
LR  - 20181202
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 116
DP  - 2016 Jun
TI  - Principles of self-adjustment of insulin dose in people with diabetes type 2 and 
      flexible insulin therapy.
PG  - 165-70
LID - S0168-8227(16)30081-X [pii]
LID - 10.1016/j.diabres.2016.04.017 [doi]
AB  - AIMS: Structured treatment and education programmes for people with type 2 
      diabetes mellitus (T2DM) and flexible insulin therapy provide rules for 
      self-adjustment of insulin dose, that are extensively trained. The aim of this 
      cohort study was to register current principles and the frequency of 
      self-adjustment of insulin dose and their association with metabolic control in 
      people with T2DM. METHODS: Details of insulin dose adjustment were assessed by a 
      structured interview in 149 people with T2DM on flexible insulin therapy (mean 
      HbA1c 7.1%/53.8mmol/mol, age 65y, diabetes duration 19.0y, BMI 33.8kg/m(2)) in a 
      tertiary care centre. The frequency of insulin dose adjustments was obtained from 
      the last 28days of the patients' diaries. RESULTS: Insulin dose adjustment by 
      adjustment rules was used by 33 people (22.1%) and by personal experience/feeling 
      in 111 participants (74.5%). People adjusting by rules were younger (60.9+/-9.8 vs. 
      65.7+/-9.2, p=0.011) and did more insulin dose adjustments per 28days (50.0+/-31.0 
      vs. 33.4+/-23.5, p=0.016). HbA1c and incidence of hypoglycaemia were comparable. 
      There were no differences in satisfaction of treatment, quality of life as well 
      as current well-being between the groups. CONCLUSIONS: Only a fifth of the 
      participants used the rule trained within the education programme to adjust their 
      insulin dose. The majority adjusted their insulin dose by personal 
      experience/feeling. However, people in both groups were able to adjust their 
      insulin dose. Although people using adjustment rules adjust their insulin dose 
      more frequently, HbA1c and the incidence of hypoglycaemia was similar compared to 
      those using personal experience/feeling.
CI  - Copyright (c) 2016 Elsevier Ireland Ltd. All rights reserved.
FAU - Kramer, G
AU  - Kramer G
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany. Electronic address: 
      guido.kramer@med.uni-jena.de.
FAU - Kuniss, N
AU  - Kuniss N
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
FAU - Kloos, C
AU  - Kloos C
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
FAU - Lehmann, T
AU  - Lehmann T
AD  - Institute of Medical Statistics, Computer Sciences and Documentation, Jena 
      University Hospital, Jena, Germany.
FAU - Muller, N
AU  - Muller N
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
FAU - Sanow, B
AU  - Sanow B
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
FAU - Lorkowski, S
AU  - Lorkowski S
AD  - Institute of Nutrition, Friedrich Schiller University Jena, Germany; Competence 
      Cluster for Nutrition and Cardiovascular Health (nutriCARD), Halle-Jena-Leipzig, 
      Germany.
FAU - Wolf, G
AU  - Wolf G
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
FAU - Muller, U A
AU  - Muller UA
AD  - Endocrinology and Metabolic Diseases, Department of Internal Medicine III, Jena 
      University Hospital, Jena, Germany.
LA  - eng
PT  - Journal Article
DEP - 20160423
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Aged
MH  - Blood Glucose Self-Monitoring/*methods
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*therapeutic use
MH  - Male
MH  - Self Care
OTO - NOTNLM
OT  - Flexible insulin therapy
OT  - Self-adjustment of insulin dose
OT  - Type 2 diabetes mellitus
EDAT- 2016/06/21 06:00
MHDA- 2016/12/16 06:00
CRDT- 2016/06/21 06:00
PHST- 2015/12/14 00:00 [received]
PHST- 2016/02/23 00:00 [revised]
PHST- 2016/04/18 00:00 [accepted]
PHST- 2016/06/21 06:00 [entrez]
PHST- 2016/06/21 06:00 [pubmed]
PHST- 2016/12/16 06:00 [medline]
AID - S0168-8227(16)30081-X [pii]
AID - 10.1016/j.diabres.2016.04.017 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2016 Jun;116:165-70. doi: 10.1016/j.diabres.2016.04.017. 
      Epub 2016 Apr 23.