Treatment in adults with type 1 diabetes mellitus: what variables affect glycemic control?

Authors

  • Eva López González University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina
  • María Ruiz Morosino Diabetology and Metabolic Diseases Clinic (CODIME), Autonomous City of Buenos Aires, Argentina
  • Alicia Beatriz García Hospital Gral. Agudos E. Tornú, Autonomous City of Buenos Aires, Argentina
  • Silvia Milrad Manuel Rocca Hospital, Autonomous City of Buenos Aires, Argentina
  • Ángela Luongo Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina
  • Solange Houssay Hospital Gral. Agudos E. Tornú, Autonomous City of Buenos Aires, Argentina
  • María Cristina Varela Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires, Argentina
  • Claudio Daniel González Austral University and University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

DOI:

https://doi.org/10.47196/diab.v48i2.207

Keywords:

type 1 diabetes, adults, intensified treatment, glycemic control

Abstract

Objectives: to analyze therapeutic modalities in T1DM and its relation with glycemic control.

Methods: a multicenter, observational study performed in people with T1DM, older than 18 years old, at 24 centers with doctors specialized in nutrition and/or diabetes, from 10/01/2011 to
09/30/2012. Data collected: a survey, laboratory tests and type of treatment. Statistics: Chi2, Spearman correlation, Multiple Logistic Regression.

Results: 514 patients were evaluated, aged 40,6±14,6 years, 55,1% female, and duration of DM1 17,4±12,0 years, mean A1C was 8,0±1,5%, mean fasting blood sugar 147,2±69,1 mg/dL, and self-monitoring frequency 3,3±1,5 times a day. A1c was <7% in 38,8% and <8 % in 60,9%. With intensified insulin therapy 75,1%, with an infusion pump 8,6%, and 62,1% counted carbohydrates, being mean A1C 7,8±1,5% with intensified treatment, and 8,4±1,7% with conventional treatment (p=0,001). 67% had hypoglycemia in the
last week, being higher in the intensified group (p=0,0001). In multiple logistic regression: physical activity (p<0,002), carbohydrate counting (p<0,04), meeting meal schedules (p=0,0001) and higher self-monitoring frequency (p=0,004) correlated with glycemic control.

Conclusions: A1C <7% was achieved in 38,8%, being intensified insulin treatment associated with better A1c and more frequency of hypoglycemia. Improved glycemic control was correlated with physical activity, meeting meal schedules, carbohydrate counting, and self-monitoring more frequently.

Author Biographies

Eva López González, University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

Nutrition Specialist and Medical Clinic; Professor attached to Nutrition, University of Buenos Aires (UBA)

María Ruiz Morosino, Diabetology and Metabolic Diseases Clinic (CODIME), Autonomous City of Buenos Aires, Argentina

Diabetology and Metabolic Diseases Clinic (CODIME)

Alicia Beatriz García, Hospital Gral. Agudos E. Tornú, Autonomous City of Buenos Aires, Argentina

Plan doctor

Ángela Luongo, Pueyrredón Medical Offices, Banfield, Province of Buenos Aires, Argentina

Nutrition Specialist

Solange Houssay, Hospital Gral. Agudos E. Tornú, Autonomous City of Buenos Aires, Argentina

Doctor, specialist in Diabetes and Nutrition

María Cristina Varela, Central Hospital of San Isidro, Dr. Melchor Posse, Province of Buenos Aires, Argentina

Physician, Nutrition Specialist

Claudio Daniel González, Austral University and University of Buenos Aires (UBA), Autonomous City of Buenos Aires, Argentina

Pharmacologist doctor; Advisor on the methodology of the clinical and epidemiological evidence qualification processes

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Published

2023-01-10

How to Cite

López González, E., Ruiz Morosino, M., García, A. B., Milrad, S., Luongo, Ángela, Houssay, S., Varela, M. C., & González, C. D. (2023). Treatment in adults with type 1 diabetes mellitus: what variables affect glycemic control?. Journal of the Argentine Society of Diabetes, 48(2), 63–69. https://doi.org/10.47196/diab.v48i2.207

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