Background: Basal insulin therapy is widely used in patients with type 2 diabetes mellitus (T2DM). After giving the initial dose, the follow-up of the patients from the doctors, including the dose adjustment and the hypoglycemia, is not sufficient in China, which influences the glucose control obviously. Thus, we intended to invest if the patients with T2DM would benefit from careful follow-up and management of the basal insulin therapy by the nurse.
Methods: The patients with T2DM who were ≥ 18 years old and glycosylated hemoglobin A1c (HbA1c) > 7% were eligible for the 12-week study. After they were randomized to the control group and the careful care group, glargine was added to them. All of the patients accepted the routine guidance by the doctor. In addition to that, patients in the careful care group were guided to adjust their insulin dose 2-6U to reach the glucose target and followed-up at the 1, 2, 4, 8, 12 weeks by the Diabetes Specialist Nurses. The laboratory indices and questionnaire were assessed at baseline and at the end of the study.
Results: Four hundred and twenty-three patients (53.6 ± 14.3 years) in the control group and four hundred and twenty-six patients (54.7 ±13.4 years) in the careful care group finished the 12-week study. The patients in the careful care group had greater reduction of fasting plasma glucose (-2.64±0.44mmol/L vs. -1.63±0.53mmol/L, P<0.05) and HbA1c (-2.8±0.5% vs. -1.8±0.5%, P<0.05), higher improvements of the score of diabetes knowledge (6.10 ± 0.76 vs. 2.87± 1.72, P<0.001), the score of Diabetes Empowerment Scale-Short Form (39.07 ± 17.82 vs. 26.93 ± 19.17, P<0.05), and the score of self-management ability (including diet, exercise, etc., P<0.05), compared with the control group. The hypoglycemic percentages were similar between them (17.73% vs. 20.65%, P=0.279).
Conclusions: The careful follow-up and management of self-insulin dose adjustment by Diabetes Specialty Nurses is effective and safe in patients with T2DM.
X. Hu: None. X. Yang: None. H. Deng: None. X. Guo: None. B. Yao: None.