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Improving glycaemic control in African diabetic patients on insulin: a resource-free approach

Gill, Geoff, Gebrekidan, A., English, P. J. and Tesfaye, S. (2009) 'Improving glycaemic control in African diabetic patients on insulin: a resource-free approach'. Tropical Doctor, Vol 39, Issue 1, pp. 3-5.

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In the resource-poor areas of the tropics, diabetic patients requiring insulin are often treated with once-daily injections of intermediate-acting insulin. Glycaemic control on this regime is usually poor. We trialled a simple change to twice-daily insulin (same total daily dose, two-thirds given in morning, and one-third in evening) in a group of 20 Ethiopian diabetic patients treated in this way. Nurse support and contact, and self-glucose monitoring were not available. After three months, the haemoglobin Alc (HbAlc) had improved from 10.5 +/- 1.8 to 8.0 +/- 1.5% (P < 0.001). No improvement occurred in the 20 control patients who remained on once-daily insulin. Among the twice-daily insulin group there was a small increase in weight and mild hypoglycaemic episodes. However, all patients were very satisfied and wished to continue the new system. We conclude that a simple change from once- to twice-daily insulin, without monitoring or support, can lead to a significant improvement in the overall glycaemic control, and is suitable for resource-limited tropical countries.

Item Type: Article
Subjects: WK Endocrine System > WK 820 Insulin and its modifications
WK Endocrine System > WK 835 Complications of diabetes
WK Endocrine System > WK 810 Diabetes mellitus
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI):
Depositing User: Users 43 not found.
Date Deposited: 22 Jun 2010 14:10
Last Modified: 06 Feb 2018 12:59


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