Shahid Muhammad, Sarfraz Aqiba, Shaikh Shiraz, Mahar Saeed Ahmed, Alam Maqsood, Shahid Nadia
Department of Endocrinology, Liaquat National Hospital and Medical College, Karachi.
Department of Community Medicine, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi.
J Coll Physicians Surg Pak. 2016 Mar;26(3):177-81.
To assess the perceptions regarding basal bolus insulin injections and the changes in blood glucose levels and glycosylated hemoglobin (HbA1c) before and after 3 months of such treatment in diabetic patients.
Quasi-experimental study.
Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2014 to March 2015.
A total of 222 diabetic patients started on basal bolus insulin injection were enrolled and asked to answer 17 questions. Those with complications of diabetes were excluded. Fasting blood glucose (FBS), random blood glucose (RBS) and HbA1c levels were checked initially, and after 3 months of getting basal bolus insulin. Paired t-test and chi-square test were used for determining p-value with significance at p < 0.05.
Majority (n=217, 97.7%) of the patients were previously taking other insulins. Before starting this treatment, the mean FBS was 260.5 ±52.2 mg/dl, RBS was 385.5 ±47.61 mg/dl and HbA1c was 12.76 ±1.92%. After 3 months of treatment, FBS improved to 117.9 ±14.2 mg/dl, RBS was 156.7 ±17.09 mg/dl and HbA1c was 7.72 ±4.41% (p < 0.001). Two hundred and sixteen (97.3%) patients believed that basal bolus insulin was started as their diabetes worsened; 157 (70.70%) thought that their blood glucose control would improve with the use of this form of insulin. One hundred and ninety four (87.4%) had fear of needle injections. Perceptions regarding hypoglycemia with this form of insulin were observed in 157 (70.7%). One hundred and twenty seven (84.1%) of the females and 51 (71.8%) of the males thought that the basal bolus insulin regimen was too expensive (p=0.032).
There were many misconceptions in patients who were started on basal bolus insulin. Marked improvement in blood glucose levels and HbA1c were observed after the use of this regimen.
评估糖尿病患者对基础-餐时胰岛素注射的认知，以及此类治疗3个月前后血糖水平和糖化血红蛋白（HbA1c）的变化。
准实验研究。
2014年12月至2015年3月，卡拉奇利亚卡特国家医院内分泌科。
共纳入222例开始接受基础-餐时胰岛素注射的糖尿病患者，并要求他们回答17个问题。排除患有糖尿病并发症的患者。在开始基础-餐时胰岛素治疗前及治疗3个月后，检测空腹血糖（FBS）、随机血糖（RBS）和HbA1c水平。采用配对t检验和卡方检验确定p值，p<0.05具有统计学意义。
大多数患者（n=217，97.7%）之前使用过其他胰岛素。开始这种治疗前，平均FBS为260.5±52.2mg/dl，RBS为385.5±47.61mg/dl，HbA1c为12.76±1.92%。治疗3个月后，FBS改善至117.9±14.2mg/dl，RBS为156.7±17.09mg/dl，HbA1c为7.72±4.41%（p<0.001）。216例（97.3%）患者认为开始基础-餐时胰岛素治疗是因为他们的糖尿病病情恶化；157例（70.70%）认为使用这种胰岛素形式可改善血糖控制。194例（87.4%）患者害怕注射针头。157例（70.7%）患者观察到对这种胰岛素形式低血糖的认知。127例（84.1%）女性和51例（71.8%）男性认为基础-餐时胰岛素治疗方案过于昂贵（p=0.032）。
开始接受基础-餐时胰岛素治疗的患者存在许多误解。使用该治疗方案后，血糖水平和HbA1c有显著改善。
