We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 p...We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn’t significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose self-adjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.展开更多
To evaluate the clinical utility for simple patient administered dose adjustment methods of insulin glargine during outpatient visits compared with a physician managed titration, changes in HbA1c and total daily dose ...To evaluate the clinical utility for simple patient administered dose adjustment methods of insulin glargine during outpatient visits compared with a physician managed titration, changes in HbA1c and total daily dose of insulin were evaluated in 23 patients by dividing patients into physician-led (PL) group and self-titration (ST) group who were newly administered glargine basal-supported oral therapy (BOT) while continuing oral antidiabetic drugs at the discretion of their attending physician during regular outpatient visits. In the PL group, one month after initiation of glargine, HbA1c followed a declining trend, although this was not significant (P = 0.07), and decreased significantly after two and three months (P < 0.05, respectively). However, after 12 months, the significant difference had disappeared. By contrast, in the ST group, HbA1c did not significantly decrease one month after initiation of glargine, but did drop markedly after two and three months, with this trend continuing up to 12 months (P < 0.005). On examining the differences between both groups, we found that the initial dose was significantly larger in the PL group (P < 0.05), whereas the dose increased significantly more in the ST group after three months. While the insulin dose after 12 months was large in the ST group, no statistically significant difference was noted between the two groups (P = 0.14) whereas HbA1c was significantly low in the ST group. In conclusion, we believe that patient-led basal insulin dosage adjustment is an effective and useful therapeutic option when they can master self-monitoring of blood glucose.展开更多
文摘We implemented a 3-3-1 algorithm in order to provide safe and simple self-titration in patients who newly initiated BOT as well as who were already on BOT and evaluated its utility in clinical setting. A total of 46 patients, 21 patients in the newly-initiated group and 25 patients in the existing BOT group performed dose adjustment using 3-3-1 algorithm. HbA1c was significantly improved 4 weeks after the initiation from 8.5% ± 1.2% at baseline to 7.3% ± 0.7% at the final evaluation (p 0.01, vs. Baseline). The average daily insulin units increased throughout the study period from 10.1 ± 6.7 at baseline to 14.6 ± 8.9 units at the final evaluation. Weight didn’t significantly change throughout the study (p = 0.12). The incidents of hypoglycemia were 0.8/month during the insulin dose self-adjustment period and 0.4/month during the follow-up period. The 3-3-1 algorithm using insulin glargine provided a safe and simple dose adjustment and demonstrated its utility in patients who were newly introduced to insulin treatment as well as who were already on BOT.
文摘To evaluate the clinical utility for simple patient administered dose adjustment methods of insulin glargine during outpatient visits compared with a physician managed titration, changes in HbA1c and total daily dose of insulin were evaluated in 23 patients by dividing patients into physician-led (PL) group and self-titration (ST) group who were newly administered glargine basal-supported oral therapy (BOT) while continuing oral antidiabetic drugs at the discretion of their attending physician during regular outpatient visits. In the PL group, one month after initiation of glargine, HbA1c followed a declining trend, although this was not significant (P = 0.07), and decreased significantly after two and three months (P < 0.05, respectively). However, after 12 months, the significant difference had disappeared. By contrast, in the ST group, HbA1c did not significantly decrease one month after initiation of glargine, but did drop markedly after two and three months, with this trend continuing up to 12 months (P < 0.005). On examining the differences between both groups, we found that the initial dose was significantly larger in the PL group (P < 0.05), whereas the dose increased significantly more in the ST group after three months. While the insulin dose after 12 months was large in the ST group, no statistically significant difference was noted between the two groups (P = 0.14) whereas HbA1c was significantly low in the ST group. In conclusion, we believe that patient-led basal insulin dosage adjustment is an effective and useful therapeutic option when they can master self-monitoring of blood glucose.
