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Assessment of factors determining an HbA1c concentration ≤7.5% in patients with type 1 diabetes
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Yamada, Eijiro, Okada, Shuichi, Nakajima, Yasuyo, Bastie, Claire C., Tagaya, Yuko, Osaki, Aya, Shimoda, Yoko, Shibusawa, Ryo, Saito, Tsugumichi, Ozawa, Atsushi and Yamada, Masanobu (2018) Assessment of factors determining an HbA1c concentration ≤7.5% in patients with type 1 diabetes. Journal of Diabetes, 10 (2). pp. 140-147. doi:10.1111/1753-0407.12572 ISSN 1753-0393.
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Official URL: https://doi.org/10.1111/1753-0407.12572
Abstract
Background:
Establishing an optimal insulin regimen is crucial for maintaining glycemic control in patients with type 1 diabetes (T1D). The aim of the present study was to determine the insulin dose required to achieve an HbA1c concentration ≤7.5% in Japanese patients with T1D.
Methods:
The present multicenter cross-sectional study was performed at three institutes in Japan. Information was collected regarding patient age, sex, body weight, body mass index (BMI), HbA1c, total daily insulin dose (TDD), and total basal insulin dose (TBD), and the effects of these factors on achieving HbA1c ≤7.5% were investigated.
Results:
Of 107 patients with T1D, 92 had no detectable endogenous insulin secretion: 39 had HbA1c ≤7.5% (well-controlled group) and 53 had HbA1c >7.5% (poorly controlled group). No significant differences in age, sex, height, body weight, BMI, diabetes duration, stage of diabetic kidney disease, treatment, or TDD were noted between the poorly and well-controlled groups. The TBD as a percentage of TDD (%TBD) was lower in patients with well-controlled diabetes ( P < 0.05) after adjustment for age, gender, and diabetes duration. In the well-controlled group, TDD was correlated with body weight ( R = 0.51), BMI ( R = 0.44), body surface area ( R = 0.41), and TBD ( R = 0.73; P < 0.01 for all), but TBD was not correlated with BMI or body surface area. In our population, a %TBD of approximately 30% was appropriate, without considering BMI.
Conclusions:
To achieve HbA1c ≤7.5 in patients with T1D, TDD should be calculated based on body weight, and the %TBD should be set at 30% in the Japanese population.
| Item Type: | Journal Article | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RZ Other systems of medicine | ||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | Journal of Diabetes | ||||||||||
| Publisher: | Wiley-Blackwell Publishing, Inc. | ||||||||||
| ISSN: | 1753-0393 | ||||||||||
| Official Date: | February 2018 | ||||||||||
| Dates: |
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| Volume: | 10 | ||||||||||
| Number: | 2 | ||||||||||
| Page Range: | pp. 140-147 | ||||||||||
| DOI: | 10.1111/1753-0407.12572 | ||||||||||
| Status: | Peer Reviewed | ||||||||||
| Publication Status: | Published | ||||||||||
| Access rights to Published version: | Restricted or Subscription Access |
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