Association Between Management of Continuous Subcutaneous Basal Insulin Administration and HbA1C
| Autor: | Ian Fox, Harry Rubin-Falcone, Joyce M Lee, Emily Hirschfeld, Jenna Wiens, Rodica Pop-Busui, Lynn Ang |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Glucose control Endocrinology Diabetes and Metabolism Biomedical Engineering Insulin delivery 030209 endocrinology & metabolism Bioengineering 03 medical and health sciences 0302 clinical medicine Insulin Infusion Systems Internal medicine Internal Medicine medicine Humans Hypoglycemic Agents Insulin 030212 general & internal medicine Child Retrospective Studies Glycated Hemoglobin Type 1 diabetes business.industry Basal insulin Original Articles medicine.disease Endocrinology Diabetes Mellitus Type 1 Female business |
| Zdroj: | J Diabetes Sci Technol |
| ISSN: | 1932-2968 |
| Popis: | Background: While we expect that patients who adjust their insulin delivery algorithms between clinic visits to have better glucose control compared to those who do not, this effect has not been quantified. Method: This is a single-center retrospective cohort study including pediatric and adult patients with type 1 diabetes evaluating insulin pump self-management behaviors. Basal insulin dose information was obtained from the Glooko-Diasend database, and used to quantify the frequency and magnitude of basal insulin daily dose adjustments within the 90-day window preceding HbA1c measurement. We use a linear mixed-effects model to analyze associations between frequency/magnitude of daily basal insulin changes and HbA1c. Results: We present data on 114 adult (44 ± 17 years, 60% female) and 212 pediatric (12 ± 4 years, 50% female) patients. Individuals changed their basal insulin dose on 72%-94% (interquartile range [IQR]) of observed days relative to the previous day. These changes varied 0.6%-2.4% IQR from the previous day’s value. In pediatric patients, lower HbA1c was associated with more frequent daily profile adjustments, while controlling for rate of hypoglycemia (z = -3.2, P = .001). In adults, there was no relationship between HbA1c and magnitude or frequency of basal profile adjustments. Conclusions: Pediatric patients who frequently modify their basal insulin exhibit somewhat better clinical outcomes, although the magnitude by which their basal amount is changed does not contribute to this effect. |
| Databáze: | OpenAIRE |
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