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      • Poster Session : PS 0153 ; Diabetes : Basal-Bolus Insulin Regimens and a Discharge-Strategy in Hospitalized Patients with Type 2 Diabetes Can Improve and Maintaining Control Glucemic During Several Years

        ( Pedro Reales Figueroa ),( Yasser Hessein Abdou ),( Maria Martin Toledano Lucas ),( Ibrahim Hamad ),( Adrian Ruiz Fernandez ),( Juan Velasco Franco ),( Marta Salas Cabanas ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Aims: Current guidelines recommend the use of a basal-bolus insulin regimen in hospitalized patients with hyperglycemia or type 2 DM. In addition a simple strategy facilitating the reconciliation of medication on discharge can improve glycemic control post-discharge. With our study we want to test whether this better glycemic control is maintained over time. Methods: Our study is a prospective and observational study during routine clinical practice. It has been held in an Department of Internal Medicine during hospitalization, with follow-up visit at 3 months after discharge and followed up for 3 years. Study patients (30) were treated with a regimen of basal-bolus insulin during hospitalization and an adjustment of their antidiabetic treatment at discharge. As a control group we included patients(30) hospitalized with similar characteristics, treated with other regimen of insulin or oral antidiabetic agents and to which either no treatment adjustment is recommended at discharge. A follow-up to all patients at 3 months after discharge and again after 3 years I realize. Results: Comparing the study group with the control group we found no differences in baseline HbA1c (8,52%±0,81 vs 8,61%±0.72; p:0,652), age (67,7±3,76 vs 67,8±3,71; p:0,86), sex (16 male vs 17 mal) and BMI (30,33±1,62 Kg/m2 vs 30,41±1,63 Kg/m2). Compared with baseline, the HbA1c at 3 months after discharge is lowe r(7,51%±0.81 vs 8,52%±0,81;p:0,001) and 3 years after discharge also remains lower(7,81%±0,81vs8,52%±0,81; p:0,013). Compared with control subjects, patients included in study have lower HbA1c at 3 months after discharge (7,51%±0,81 vs 8,71% ± 0,81:p:0,004) and lower HbA1c at 3 years after discharge (7,81%±0,81 vs 8,91%±0,81; p:0,002). Conclusion: This study confi rm that protocols to manage hyperglycemia with basal-bolus insulin regimens are also feasible and effective in routine clinical practice, and demonstrate that a simple strategy facilitating the reconciliation of medication on discharge can improve glycemic control post-discharge, that remains after 3 years or follow.

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