RESUMEN
This cross-sectional multicentric study was carried out by 7 Tunisian centers in the aim to describe their behavior about permanent insulin treatment, for there type 2 diabetic patients. Three hundred patients were included, aged 59.2 +/- 0.6 years, whose BMI was 2 7.3 +/- 0.28 kg/m2 and diabetic duration was 10.2 +/- 0.4 years at the time of insulin treatment. Most of them were previously treated by the association of glibenclamide and metformin with a fasting glycaemia at 16.7 +/- 0.3 mmol/l and HbAC at 11.1 +/- 0.2%. The insulin treatment was indicated in 68% of the cases by a chronic poor control, in 7.3% by an acute decompensation and in 20% by degenerative complications. Insulin regimen included 2 daily injections [60% of the cases]. Oral agents were stopped in 77% of the cases. After a mean delay of 3.6h0.2 years, the average insulin dose was 0.5610.02 UI/kg/j, the, fasting glycaemia was lowered by 7.0 +/- 0.4 mmol/l and the HbA1c by 2.2 +/- 0.2%. The investigators estimate that the insulin treatment was justified in 77% of the cases and was inevitable in 11%
RESUMEN
We conducted this study to determine quality of glycemic control in patients with type 1 diabetes, based on evaluation of mean HbA1c. We enrolled 125 patients with type 1 diabetes who were hospitalized during the period from December 1998 to December 2001. Glycemic control was evaluated on mean of HbA1c in 82 patients and on mean of fasting glycemia values in 43 patients. Mean HbA1c was 9,9%. Mean of plasma fasting glycemia was 11 mmol/l. 22 % of patients were perfectly or good controlled [HbA1c 5 7% or HbA1c 7 - 7,5 %]. 12 % had a moderate control [HbA1c 7,5 et 9%] and finally 66%, of patients had a worse control [HbA1c > 9%]. There was an excellent correlation between HbA1c and mean fasting glycemic values [p = 0,00028]. Most of patients had unsatifactory control. We stressed on the absolute necessity of intensified insulin therapy and self-monitoring blood glucose