Treatment in adults with type 1 diabetes mellitus: what variables affect glycemic control?
DOI:
https://doi.org/10.47196/diab.v48i2.207Keywords:
type 1 diabetes, adults, intensified treatment, glycemic controlAbstract
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.
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