We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Optimizing insulin delivery: assessment of three strategies in intensive diabetes management.
- Authors
Kalergis, M.; Pacaud, D.; Strychar, I.; Meltzer, S.; Jones, P. J. H.; Yale, J. -F.
- Abstract
SUMMARY Objective To compare three intensive management strategies with respect to metabolic control (glycated haemoglobin, preprandial blood glucose, lipid profile, body weight, hypoglycaemic episodes) and psycho-social adaptation (quality of life, self-efficacy, stress and perceived complexity). Research Design and Methods: Fifteen adults with type 1 diabetes completed this 1-year, randomized, prospective, cross-over study. The three treatment strategies were categorized according to flexibility with insulin self-adjustments as follows: Simplified (SIMP) = meal plan based on food exchanges with no self-adjustments of insulin for food, exercise and stress; Qualitative (QUAL) = meal plan based on food exchanges with qualitative adjustment of insulin for food, exercise and stress; Quantitative (QUANT) = meal plan using carbohydrate counting with quantitative adjustment of insulin for food and qualitative adjustment for exercise and stress. All three strategies allowed for adjustments of insulin for preprandial blood glucose and the option of adjusting diet for exercise. All subjects followed each strategy for 3.5 months. Subjects kept detailed log sheets where they recorded preprandial blood glucose, insulin dosages, food intake, activity and stress level at least four times/day. The psycho-social aspects were determined with validated questionnaires that were completed before and after each strategy. Results There were no statistically significant differences in metabolic control, quality of life and self-efficacy between the three strategies. The mean (± s.e.) for HbA1 levels (normal < 8.5%) were: Baseline: 10.9 ± 0.06 and End of SIMP = 9.7 ± 0.03; QUAL = 9.5 ± 0.04; QUANT = 10.2 ± 0.04. Body weight and serum lipid levels did not change significantly. The frequency of severe hypoglycaemic episodes for the entire study was 20 episodes/100 patient-years. Perceived complexity of treatment strategy increased (p...
- Subjects
TREATMENT of diabetes; PEOPLE with diabetes; GLYCOSYLATED hemoglobin; BLOOD sugar; LIPIDS
- Publication
Diabetes, Obesity & Metabolism, 2000, Vol 2, Issue 5, p299
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1046/j.1463-1326.2000.00107.x