RESUMO
INTRODUCTION: Controlling postprandial glycemia (PPG) is important to achieve optimal glycemic control, but few studies have evaluated how often is measured and evaluated. OBJECTIVES: To evaluate how often patients on insulin therapy measure PPG and modify insulin doses accordantly. As secondary objectives, we evaluated the factors conditioning elevated PPG and associated issues. MATERIAL AND METHODS: Cross-sectional observational study based on a web-based survey from an unselected sample of adult insulin-treated patients. A p-value ofâ¯<â¯0.05 was significant. RESULTS: 1251 patients (68% women, 38.9⯱â¯13â¯years [mean⯱â¯SD], body mass index (BMI) 24.2⯱â¯4.2â¯kg/m2, diabetes duration 17.4⯱â¯12.8â¯years, insulin dose 38⯱â¯18â¯IU) participated, 1104 with autoinmmune disease (AD) and 147 with non-autoinmmune diabetes (NAD). 59% of patients had HbA1câ¯≤â¯7%, 92.7% of patients with AD and 55.8% with NAD were attended by specialists (pâ¯<â¯0.001). People with AD did more often blood glucose monitoring (BGM) (pâ¯<â¯0.0001) and used continuous glucose monitoring systems (CGMS) (pâ¯<â¯0.0001). 90.1% with AD and 68.0% with NAD received instructions on measuring PPG (pâ¯<â¯0.001), and more with AD received specific training to change the treatment (87% vs. 61.2%, pâ¯<â¯0.0001) and were more proactive. However, more with NAD discussed their postprandial glucose levels with their healthcare team during clinical visits (92.5% vs. 74.1%, pâ¯<â¯0.0001). Regarding bolus administration, 88.6% with AD and 68.7% with NAD injected the insulin bolus before meals (pâ¯<â¯0.001). CONCLUSIONS: Patients with AD determine PPG more frequently. Diabetes type, follow-up setting, number of injections and CGMS use were the most important predictive factors for PPG measurement. Diabetes education programs should address how to best monitor PPG and appropriate corrective actions.