|
| BODY
MASS AND BLOOD PRESSURE CONTROL IN PATIENTS WITH TYPE 1 DIABETES
MELLITUS WITH DIFFERENT INSULIN REGIME |
|
I. Kulenović1 and S. Alajbegović |
| Clinic
of Endocrinology, Diabetes and Metabolic Disorders1, Clinical
Centre University of Sarajevo, Cantonal Hospital Zenica2 Bosnia
and Herzegovina |
Without optimal
insulin treatment, we can not achieve acceptable level of glycoregulation,
avoid dislippoproteinaemia and maintain body mass in patients
with type 1 diabetes mellitus (DM). On the other hand it is sometimes
difficult to prevent weight gain, endogenous hyperlipidemia and
iatrogenic insulin resistance. Aim: to compare metabolic control
indicators in patients with type 1 DM in patients treated conventionally
to those on intensified insulin regime. Methods: A random sample
of 52 persons with type 1 DM. Without late complications and long
duration of the disease, was selected.Among them 19 (36,5%) were
treated with insulin in 4 doses, and 33 (63,5%) conventionally,
in 2 doses.They had biochemical indicators of metabolic control
determined (glycosylated Hb, fasting and postprandial glycaemia,
total cholesterol,trygliceridies as well as lipoprotein fractions,
HDLC i LDLC),body height (BH) and weight (BW) measured, body mass
index calculated (BMI) and blood pressure measured (BP). Results:
In the conventionally treated group we found significantly higher
mean values of BMI as compared to those on intensified insulin
regime (23,2+-2,0 kg/m2, and 21,2+-1,2 kg/m2 respectively, p<0,05)
and proportion of overweight participants was as well significantly
higher (27,3% versus 0%, p<0,05).We noted higher mean values of
systolic (134,2+-17,6 mmHg,versus 123,4+-12,7, p<0,05) and diastolic
(83,2+-10,1, versus 74,0+-9,7, p<0,01) BP.Biochemical indicators
of glyco and liporegulation were significantly worse, with, at
the same time higher total dose of applied insulin (55,9+-8,5
IU, versus 46,3+-10,0 IU, p<0,01), and insulin units per kg of
body weight (0,84+-0,11 IU/kg versus 0,77+-0,15 IU/kg, p<0,05).
Conclusion: Results indicate that intensified insulin treatment
is more favourable variant of treatment, by which the certain
level of insulin resistance, which might be present in patients
treated with two higher insulin doses, is probably reduced.Therefore
it improves metabolic outputs, blood pressure and body mass values.
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