27 November 2011 (Sunday) - Diabetes
It is commonly felt that patients with type II diabetes treated with oral therapy alone rarely achieve the recommended 7% HbA1c goal for glycemic control. As control worsens over time, the risks of the complications which are common to the diabetic patient increase.
Traditionally doctors can be loathe to use insulin therapy in the type II diabetic patient (for a variety of reasons), and when insulin is prescribed, it is often not prescribed in a sufficiently aggressive dosage.
A recent survey has shown that supplementing oral therapy with a single injection of insulin given at bed time can routinely lower fasting glucose measurements, and achieves and surpasses the recommended target of 7% for HbA1c levels.
Furthermore the use of glargine (a new long-acting insulin analog) rather than more traditional insulin analogues can achieve this reduction in fasting glucose measurements and HbA1c levels whilst significantly reducing the incidence of nocturnal hypoglycaemia; with about a third of all patients having no incidents of nocturnal hypoglycaemia at all. With patient adherence to the treatment protocol exceeding 90%, this regimen is easy to follow.
Labels: journal review