Glycemic control and treatments in adults with type 1 diabetes mellitus
Husniye Baser, Cevdet Aydin, Ahmet Dirikoc, Dilek Arpaci, Reyhan Ersoy & Bekir Cakir
Introduction: Survival is increased in childhood-onset type 1 diabetes mellitus (DM) and approximately half of patients are diagnosed after the age of 15. Thus, a considerable number of patients with type 1 DM are adults. In this study, we aimed to investigate glycemic control and modalities of treatments in adult type 1 DM patients.
Material and methods: Data of type 1 DM patients hospitalized between January 2004 and December 2009 were evaluated retrospectively. Age at diagnosis, duration of diabetes, HbA1c levels and type of insulin treatment were recorded. Data at the time of initial hospitalization were analyzed in patients with multiple hospitalizations.
Results: Two hundred and fifty patients were included in the study. There were 123 (49.2%) female and 127 (50.8%) male patients. The mean age of patients at the time of hospitalization was 31.9±9.7, mean age at diagnosis was 24.7±10.1, and duration of diabetes was 7.2±8.4 years. Type 1 DM was diagnosed at the age of 014 in 15.2%, 1530 in 54.8% and >30 in 30% of patients. HbA1c was >9.5% in 49.6%, 7.59.5% in 27.6% and <7.5% in 22.8% of patients. Sixty percent of patients was using four daily injections of insulin treatment and 27% was using one, two or three daily injections. 13% of patients was on insulin pump therapy. When we compared HbA1c in patients using different insulin regimens, we found that patients using insulin pump had significantly lower HbA1c levels (P<0.01).
Conclusion: In the adult population, type 1 DM is diagnosed with increasing frequency. In adult type 1 DM patients metabolic control is not well and the goal of near normoglycemia is achieved in few patients. Additionally, patients on insulin pump therapy have the best glycemic control.