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Journal : Journal of the Indonesian Medical Association

Glycemic Control in Switching Insulin-based Regimen Among Type 2 Diabetic Patients Soewondo, Pradana; Subekti, Imam
Journal of the Indonesian Medical Association Vol. 61 No. 11 November 2011
Publisher : Journal of the Indonesian Medical Association

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Abstract

Appropriate diet and physical activity, maintaining a healthy body weight and propercontrol of diabetes using oral anti diabetic (OAD) in people with diabetes type 2 will helpreduce its complications. However, some advance diabetic cases need insulin-based regimen toaggressively lower blood glucose level. Local data was insufficient to determine whether type 2diabetes patients on insulin were indeed attaining glycemia goals. The aim of this study was toassess the clinical response of type 2 diabetic patients who were switched to another insulinregimen to achieve glycemic control. The study was performed as a non-interventional prospective disease registry that mirror real life management of these subjects after a 3 month follow up. To assess the clinical response, we performed measurement of fasting blood glucose level, HbA1c, waist circumference and body weight. One hundred and fifteen type 2 diabetes patients who were already on insulin therapy with unsatisfactory control of glycaemia parameters were admitted in this study of an actual clinical setting. Only 93 cases have been examined in a 3 month follow up. Premix, Short-acting and Intermediate-acting insulin were the most popular insulin-based regimens that previously been prescribed, while basal analogue insulin is the most common regimen for switching therapy. The newly prescribed insulin-based regimen showed significant reduction of important glycaemia parameters such as fasting blood glucose level and HbA1c. Serum blood glucose was decreased 61.76 mg/dL (p<0.001) and the level of HbA1c was also decreased 1.39 unit (p<0.001). In addition, waist circumference was significantly reduced for 0.70 cm (p=0.041). However, there was a slight increase of body weight althoughnot statistically significant (p=0.389). We concluded that switching insulin-based regimen for unsatisfactory although glycemic control patient gave the probability to improve clinical response. J Indon Med Assoc. 2011;61:429-34.Keywords: Type 2 diabetes, Indonesia, insulin-based, switching regimen, Glycemic control
Co-Authors -, Rosidi Abdul Aziz Rani Abdul Ghofar Aditya Pramudita Ali I. Mukhsin Alshrife, Fouad Mohammed Ari Fahrial Syam Asman B. Ranakusuma Aulia Fuad Rahman Bambang Purnomosidhi Bambang Subroto Dante S Harbuwono, Dante S Dante S. Harbuwono Dante Saksono Harbuwono, Dante Saksono Denissa Nadya Tiffany Diah Martina, Diah Dono Antono Dyah Puspasari, Dyah Edhi Martono Edy Suandi Hamid Ellis Afri Zumaila Em Yunir, Em Endang Mardiati Esthika Dewiasty, Esthika Fajar Lazuardi Sofwan Fakhriyyah, Dewi Diah Fariz Hermawan Fuad, Aulia Gracia Masita Hari Hendarto, Hari Indah Putri Utami Inke Livia Jacobus Albertus Komarudin Achmad Krisdiantoro, Yuyut Krishna Adi Wibisana, Krishna Adi Kurniasari Novi Hardanti Laurentius A Pramono, Laurentius A Laurentius A. Pramono Laurentius Aswin Pramono Maksum, Umar Malawat, Fadli Fendi Marcellus Simadibrata Meliana Octavia, Meliana Mohamad Fadhli Azhmi Murdani Abdullah Nadia Damayanti Nesi, Antonius Noval Adib Novita Ayu Chandra Dewi Novita Dewi ONIZ ULFA PERMATA Pradana Soewondo Pramuki, Ni Made Wisni Arie Pratiwi, Eva Fauzia Dian Prima Ramdani Ariesty Pringgodigdo Nugroho, Pringgodigdo Priyatna Bagus Susanto Purnamasari, Fitri Putri, Ronasari Mahaji Rifqi, Robith Abdullah Rino Alvani Gani Rosidi Rosidi Sari Atmini Sarwono Waspadji Sidartawan Soegondo Slamet Suyono Suharko Soebardi Sulistianingtyas, Veronica Sutrisno sutrisno Taniawati Supali Totallia, Yayuk Tri J.E. Tarigan Unti Ludigdo Vajriyanti, Eva Wardani, Pramita Sukma Widya, Yeney Wismandari Wisnu Yeney Widya Prihatiningtias Yessica Natalia Yuro Bimo Kusumo Zaki Baridwan