Safety and Efficacy in Early Insulin Initiation as Comprehensive Therapy for Patients with Type 2 Diabetes in Primary Health Care Centers
ABSTRACT: to analyze the
safety and effcacy of early insulin initiation therapy for patients with type 2
diabetes mellitus (T2DM) in primary health care provided by general
practitioners (GPs) in Surabaya, East Java, Indonesia. Methods: pre-post study
of ninety nine diabetic patients without previous insulin treatment with HbA1c
levels >8% were involved in this study. The study was conducted in 10
primary health care centers in Surabaya between October 2011 to June 2012. Each
patient received insulin therapy for 12 weeks. Laboratory examination was
performed for each patient including fasting plasma glucose (FPG), 2 hours
post-prandial plasma glucose (2hPPG) and HbA1c examination before and after the
study. Self monitoring blood glucose (SMBG) examination was conducted in order
to adjust the insulin dose and prevent the incidence of hypoglycemia. Data was
statistically analyzed using paired-T test. Results: FPG level was decreased
from baseline data (209 mg/dL) to 152.07 mg/dL at the end of the study (Δ56.93
mg/dl; p=0.0001). The average of 2hPPG level was also decreased from 313.00
mg/dl to 220.72 mg/dL (Δ 92.28 mg/dL; p=0.0001). HbA1c was reduced from 11.60%
at baseline to 8.95% at the end of study (Δ 2.65%; p=0.0001). Hypoglycemia was
found in 6 patients (6.06%) in this study, but all events were mild and did not
need to be admitted to hospital. Conclusion: the safety of insulin therapy
iniatiation might be provided by GPs at primary health centers with signifcant
effcacy and minimal side effects.
Author: Agung Pranoto, Hermina
Novida, Jongky H. Prajitno, Askandar Tjokroprawiro
Journal Code: jpkedokterangg150253
