Determinants of intensive insulin therapeutic regimens in patients with type 1 diabetes : data from a nationwide multicenter survey in Brazil

• Autor(a) principal: Gomes, Marília de Brito
• Data de Publicação: 2014
• Outros Autores: Negrato, Carlos Antônio, Cobas, Roberta Arnoldi, Tannus, Lucianne Righeti Monteiro, Gonçalves, Paolla Ribeiro, Silva, Pedro Carlos Barreto da, Carneiro, João Regis Ivar, Costa, Alessandra Saldanha Matheus Fernandes da, Dib, Sérgio Atala, Azevedo, Mirela Jobim de, Nery, Márcia, Rodacki, Melanie, Zajdenverg, Lenita, Montenegro Júnior, Renan Magalhães, Sepulveda, Janice, Calliari, Luís Eduardo Procopio, Jezini, Deborah Laredo, Braga, Neuza, Luescher, Jorge L., Berardo, Renata Szundy, Arruda-Marques, Maria Carmo, Noronha, Renata Maria de, Della Manna, Thais, Salvodelli, Roberta, Penha, Fernanda Garcia, Foss, Milton Cesar, Foss-Freitas, Maria Cristina, Pires, Antonio Carlos, Robles, Fernando Cesar, Guedes, Maria de Lourdes da Silva, Dualib, Patricia Medici, Silva, Saulo Cavalcanti da, Sampaio, Emerson, Rea, Rosangela Roginski, Faria, Ana Cristina Ravazzani de Almeida, Tschiedel, Balduíno, Lavigne, Suzana Coelho de, Canani, Luis Henrique Santos, Coral, Marisa Helena Cesar, Pereira, Daniela Aline, Araújo, Luiz Antônio de, Tolentino, Monica, Pedrosa, Hermelinda Cordeiro, Prado, Flaviane A., Rassi, Nelson, Araujo, Leticia B., Fonseca, Reine Marie Chaves, Guedes, Alexis Dourado, Matos, Odelissa S., Palma, Catia C. Sousa, Azulay, Rossana Santiago de Sousa, Forti, Adriana Costa e, Façanha, Cristina Figueiredo Sampaio, Montenegro, Ana Paula, Melo, Naira Horta, Rezende, Karla Freire, Ramos, Alberto, Felicio, João Soares, Santos, Flavia M., Brazilian Type 1 Diabetes Study Group
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFRGS
• Texto Completo: http://hdl.handle.net/10183/107342
• topic: Diabetes mellitus tipo 1; Insulina; Type 1 diabetes; Chronic complications; Insulin regimens; Brazil

Background: To evaluate the determinants of intensive insulin regimens (ITs) in patients with type 1 diabetes (T1D). Methods: This multicenter study was conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. Data were obtained from 3,591 patients (56.0% female, 57.1% Caucasian). Insulin regimens were classified as follows: group 1, conventional therapy (CT) (intermediate human insulin, one to two injections daily); group 2 (three or more insulin injections of intermediate plus regular human insulin); group 3 (three or more insulin injections of intermediate human insulin plus short-acting insulin analogues); group 4, basal-bolus (one or two insulin injections of long-acting plus short-acting insulin analogues or regular insulin); and group 5, basal-bolus with continuous subcutaneous insulin infusion (CSII). Groups 2 to 5 were considered IT groups. Results: We obtained complete data from 2,961 patients. Combined intermediate plus regular human insulin was the most used therapeutic regimen. CSII was used by 37 (1.2%) patients and IT by 2,669 (90.2%) patients. More patients on IT performed self-monitoring of blood glucose and were treated at the tertiary care level compared to CT patients (p < 0.001). The majority of patients from all groups had HbA1c levels above the target. Overweight or obesity was not associated with insulin regimen. Logistic regression analysis showed that economic status, age, ethnicity, and level of care were associated with IT (p < 0.001). Conclusions: Given the prevalence of intensive treatment for T1D in Brazil, more effective therapeutic strategies are needed for long term-health benefits.