The efficacy of multiple daily insulin injection (MDI) and patient's satisfaction with MDI regimen among Filipinos.
- Author:
Young James K.
;
Gonzales-Gallenero Maria Gabriel
;
Costelo Evangeline P.
;
Tan Gerry H.
- Publication Type:Journal Article
- Keywords: Insulin Injection
- MeSH: Human; Male; Female; Aged; Middle Aged; Adult; Blood Glucose; Diabetes Mellitus, Type 2; Insulin; Insulin Infusion Systems; Outpatients; Philippines; Physician-patient Relations; Prospective Studies; Quality Of Life; Treatment Outcome
- From: Philippine Journal of Internal Medicine 2010;48(3):34-37
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND: The long term complications of diabetes lead to diminished quality of life. As a means to avoid these complicationss, insulin therapy had evolved into a specialized regimen to achieve physiologic control of blood glucose, the so-called Multiple Daily Insulin (MDI) regimen which is a relatively new technique in the Philippines.
OBJECTIVE: To study the efficacy of Multiple Daily Insulin regimen in controlling plasma glucose and to evaluate patient's satisfaction with MDI regimen among Filipino type 2 diabetics who have been on MDI for at least 2 months.
RESEARCH DESIGN AND METHODS: Filipino patients (n=107) with uncontrolled diabetes were included in the study protocol. The majority were male, more than 60 years old and had been diabetic for more than 6 years. The mean body mass index was 27 kg/m2 and the mean baseline HbA1c was 9.2% + 2.65. This prospective cohort study was conducted between January 2006 to September 2008 at Cebu Doctors University Hospital Out-Patient Department. Efficacy was evaluated by HbA1c and treatment satisfaction was assessed with the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Enrolled patients were followed up at week 12, 24 and 48.
RESULTS: Mean HbA1c fell by 2.43 + 2.68 at week 12, 2.03 + 2.35 at week 24 and 1.73 + 2.23 at week 48 showing a statistically significant decrease of HbA1c among the 3 groups was not statistically significant (p = 0.52). The proportion of patients achieving an HbA1c of < 7% at week 12, 24, and 48 were 42%, 52% and 42%, respectively. Treatment satisfaction improved significantly (p = 0.000) with MDI regimen using the DTSQ at the end of the study.
CONCLUSION: Multiple Daily Insulin Regimen is an effective treatment modality based on a significant lowering of HbA1c among the study population with uncontrolled type 2 diabetes mellitus. Patients were satisfied with the ragimen based on the positive treatment satisfaction. This, however, is contrary to popular belief that patients' quality of life is affected by insulin administration. Keywords: Multiple Daily Insulin Injection, Type Diabetes Mellitus, Treatment Satisfaction.