Insulin therapy in patients with type 2 diabetes mellitus: a focus on therapeutic education

• Anna R. Volkova
• Anna V. Lisker
• Galina V. Semikova
• Valentina S. Mozgunova

Abstract

Insulin therapy for type 2 diabetes mellitus (T2DM) is widely used in clinical practice. Despite the use of high doses of insulin, the majority of patients do not reach their treatment goals. Patient education for people with T2DM on insulin therapy seems to be an important element in achieving glycemic control.

Aim: to evaluate the efficacy of therapeutic patient education with T2DM on different regimens of insulin therapy.

Material and methods. 116 patients with T2DM were examined on various regimens of insulin therapy. Hemoglobin A1c, total daily insulin dose, body mass index were measured; hypoglycemic episodes were assessed. Some of the patients continued their education in group sessions. A year later, patients (n=84) were examined during rehospitalization.

Results. The total daily insulin dose in patients on basal-bolus therapy was higher than in patients on basal insulin therapy and mixed insulin (p<0.001; p=0.01). The rate of hypoglycemia was higher in patients on basal-bolus therapy than in patients on other regimens of insulin therapy. In the group of patients within the educational program, 65.6% of participants achieved the individual goals of Hemoglobin A1c after 1 year which is significantly higher than the baseline - 21.8% (p<0.001).

Conclusion. Basal-bolus insulin therapy has no advantages over other insulin therapy regimens in achieving the goals of Hemoglobin A1c. It is associated with a higher total daily insulin dose, body mass index and frequent hypoglycemic episodes. Education of patients with T2DM on insulin therapy can reduce the total daily insulin dose and body weight, as well as improve glycemic control and reduce hypoglycemic episodes.

Keywords:type 2 diabetes mellitus, insulin therapy, therapeutic education, hypoglycemia, glycemic control

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