Características clínicas, esquemas de tratamiento, grado de control y variables asociadas a este en una cohorte de adultos con diabetes mellitus tipo 1 en un centro terciario / Clinical features and management of 205 adults with type 1 diabetes mellitus
Rev. méd. Chile
;
147(4): 451-457, abr. 2019. tab, graf
Artículo
en Español
| LILACS
| ID: biblio-1014246
ABSTRACT
Background:
Few studies have evaluated the details of insulin therapy for type 1 diabetes mellitus (T1D) in Chile.Aim:
To describe clinical features and treatment details of adults with T1D and its association with metabolic control. Material andMethods:
Review of medical records of patients with T1D treated in a clinical network. Demographic and clinical features, types and doses of insulin and glycated hemoglobin levels were registered. The use flash glucose monitors (FGM) and insulin pumps (CSII) were also recorded.Results:
205 records were reviewed, with T1d lasting 12 ± 10 years. Twenty six percent had hypothyroidism, 1% had celiac disease, 12% had hypertension, 20% had dyslipidemia; 13% had diabetic retinopathy, 2% had diabetic nephropathy, 8% had neuropathy and 2% cardiovascular diseases. Mean body mass index was 25 kg/ m2 and mean glycated hemoglobin was 8%. Eighty-two percent used multiple daily injections, 18% used CSII and 24% used FGM. As basal insulin, 35% used slow acting analogs and 65% used ultra-slow analogs. As rapid acting insulin, 69 patients used Lispro, 79 Aspart and 50 Glulisin. Bolus doses were calculated using only capillary glucose in 22%, while 78% also considered carbohydrate consumption. Variables significantly associated to better control were the use of carbohydrates for dosing rapid insulin (A1c 7,85% vs 8,59%, p = 0,008), use of CSII (A1c 7,36% vs 8,16%, p = 0,008), and basal dose < 0,4 U/kg (A1c 7,81% vs 8,58%, p = 0,003). There were no differences regarding insulin type or use of FGM.Conclusions:
The use of formulas considering carbohydrates for dosing rapid insulin, use of infusion pumps and physiological doses of basal insulin are significantly associated with a better metabolic control in adults with T1d.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Diabetes Mellitus Tipo 1
/
Hipoglucemiantes
/
Insulina
Tipo de estudio:
Estudio observacional
/
Factores de riesgo
Límite:
Adulto
/
Femenino
/
Humanos
/
Masculino
País/Región como asunto:
America del Sur
/
Chile
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Pontificia Universidad Católica de Chile/CL
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