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  • The basal to total insulin ...
    Castellano, Elena; Attanasio, R.; Giagulli, V. A.; Boriano, A.; Terzolo, M.; Papini, E.; Guastamacchia, E.; Monti, S.; Aglialoro, A.; Agrimi, D.; Ansaldi, E.; Babini, A. C.; Blatto, A.; Brancato, D.; Casile, C.; Cassibba, S.; Crescenti, C.; De Feo, M. L.; Del Prete, A.; Disoteo, O.; Ermetici, F.; Fiore, V.; Fusco, A.; Gioia, D.; Grassi, A.; Gullo, D.; Lo Pomo, F.; Miceli, A.; Nizzoli, M.; Pellegrino, M.; Pirali, B.; Santini, C.; Settembrini, S.; Tortato, E.; Triggiani, V.; Vacirca, A.; Borretta, G.

    Journal of diabetes and metabolic disorders, 12/2018, Letnik: 17, Številka: 2
    Journal Article

    Objective To evaluate the basal/total ratio of daily insulin dose (b/T) in outpatients with diabetes type 1 (DM1) and type 2 (DM2) on basal-bolus regimen, by investigating whether there is a relationship with HbA1c and episodes of hypoglycemia. Methods Multicentric, observational, cross-sectional study in Italy. Adult DM1 ( n  = 476) and DM2 ( n  = 541) outpatients, with eGFR >30 mL/min/1.73 m 2 , on a basal-bolus regimen for at least six months, were recruited from 31 Italian Diabetes services between March and September 2016. Clinicaltrials.gov ID: NCT03489031. Results Total daily insulin dose was significantly higher in DM2 patients (52.3 ± 22.5 vs. 46 ± 20.9 U/day), but this difference disappeared when insulin doses were normalized for body weight. The b/T ratio was lower than 0.50 in both groups: 0.46 ± 0.14 in DM1 and 0.43 ± 0.15 in DM2 patients ( p  = 0.0011). The b/T was significantly higher in the patients taking metformin in both groups, and significantly different according to the type of basal insulin (Degludec, 0.48 in DM1 and 0.44 in DM2; Glargine, 0.44 in DM1 and 0.43 in DM2; Detemir, 0.45 in DM1 and 0.39 in DM2). The b/T ratio was not correlated in either group to HbA1c or incidence of hypoglycemia (<40 mg/dL, or requiring caregiver intervention, in the last three months). In the multivariate analysis, metformin use and age were independent predictors of the b/T ratio in both DM1 and DM2 patients, while the type of basal insulin was an independent predictor only in DM1. Conclusion The b/T ratio was independent of glycemic control and incidence of hypoglycemia.