[Outpatient insulin therapy in type II diabetes: program evaluation and calculation of cost saving].

BACKGROUND

Evaluation of the results of a program of outpatient insulinization in type II diabetes and the resulting saving in cost.

METHODS

Data from 39 patients with that disease (mean age 62 years) were evaluated four months after the beginning of insulin therapy and diabetic education. The economic cost of the outpatient program was calculated and compared with the cost if patients had been admitted.

RESULTS

A good metabolic control was achieved with a significant reduction (p less than 0.001) of the glycemic levels from 281 +/- 43 mg/dl (15.6 +/- 2.4 mmol/l) to 156 +/- 22 mg/dl (8.6 +/- 1.5 mmol/l). Fructose levels were reduced from 4.7 +/- 0.54 mmol/l to 3.29 +/- 0.51 mmol/l. Seventeen patients had some episode of mild hypoglycemia. The insulin dose was increased from 0.27 +/- 0.06 U per kg and day to 0.42 +/- 0.1 (11 patients required two insulin doses). At onset, no patient controlled the glycemia at home, while at the end of the program 46% did so. The evaluation of each educational end-point showed a mean of 4.8 +/- 0.3 (from 0 to 5); the end-point with the best score were the technical aspects. The economic cost of the program was 230.39 ptas per patient and day, versus 1351.75 ptas per patient and day if the patients had been admitted.

CONCLUSIONS

Outpatient insulinization in type II diabetes has very good results and is economically effective provided the adequate equipment and facilities are available.