Mealtime insulin bolus adherence and glycemic control in adolescents on insulin pump therapy

被引:0
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作者
Engelina Spaans
Kornelis J. J. van Hateren
Klaas H. Groenier
Henk J. G. Bilo
Nanne Kleefstra
Paul L. P. Brand
机构
[1] Isala,Diabetes Center
[2] Isala Women and Children’s Hospital,Department of General Practice
[3] Langerhans Medical Research Group,Department of Internal Medicine
[4] University of Groningen and University Medical Center Groningen,UMCG Postgraduate School of Medicine
[5] University of Groningen and University Medical Center Groningen,undefined
[6] University of Groningen and University Medical Center Groningen,undefined
来源
关键词
Adherence; Mealtime bolus; Type 1 diabetes; Adolescent; Self-management; Insulin pump;
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摘要
Poor self-management contributes to insufficient glycemic control in adolescents with type 1 diabetes (T1DM). We assessed the effects on glycemic control of adherence to self-measurement of blood glucose (SMBG) and insulin boluses in 90 adolescents with T1DM on insulin pump therapy over a 2-month period. We compared the number of insulin boluses and SMBGs around main meals to the “gold standard” of optimal diabetes management (SMBGs and a bolus before each main meal and SMBG before bedtime). The mean (95% CI) HbA1c levels were 2.9(1.7 to 4.0) mmol/mol lower for every additional insulin bolus and 3.1(1.6 to 4.5) mmol/mol lower for every additional SMBG. Patients performing SMBG and bolusing around each main meal had considerably lower HbA1c levels than those unable to do (95% CI for difference 4.3 to 10.4 mmol/mol and 11.5 to 20.1 mmol/mol respectively). For each additional mealtime bolus/day, the odds ratio of achieving target HbA1c levels of <58 mmol/mol was 6.73 (95% CI 2.94–15.38), after adjustment for gender, age, diabetes duration, and affective responses to SMBG in a multiple logistic regression model.
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页码:1831 / 1836
页数:5
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