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Item #7
Splitting
Evening Insulin Regimen Improves Nocturnal Hypoglycemia
A
split evening regimen reduces the risk of nocturnal hypoglycemia
and improves control in patients with type 1 diabetes mellitus.
In a study supported by the Juvenile Diabetes Research Foundation
International, investigators from the University of Perugia in
Perugia, Italy, evaluated the effects of splitting the evening
insulin treatment regimen on the known risk for nocturnal
hypoglycemia during intensive insulin treatment.
Twenty-two C-peptide-negative type 1 diabetics, mean age of 29 ±
three years, were randomly assigned to receive one of two insulin
regimens for four months and then switched to the other regimen
for an additional four months. The regimens were either a mixed
treatment of human regular and NPH insulin administered before
dinner or a split treatment with human regular insulin at dinner
and NPH insulin at bedtime.
Results showed that fewer episodes of nocturnal hypoglycemia
occurred per patient per day during the split regimen compared
with the mixed regimen (0.10 ± 0.02 versus 0.28 ± 0.04).
Patients also had significantly lower fasting blood glucose
levels, less variable fasting blood glucose levels and lower
hemoglobin A1c values while they were receiving the
split regimen.
Splitting the evening insulin treatment regimen reduces the risks
for nocturnal hypoglycemia and hypoglycemia unawareness, and
decreases hemoglobin A1c, the investigators conclude.
Ann
Intern Med 2002; 136: 504-514
Did
You Know:
The
new recommendations from ACE is for people with diabetes to keep
their A1c as close to 6.5% as possible.
Since the A1c test is the best test to use in determining
how well a patient’s diabetes is controlled over time and it is
critical that the patients know their A1c level and understand
what it means so they can have goals that are attainable.
To
have an instant A1c test that gives results in 8 minutes and is
approved for home and office use go to www.A1cNow.net
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