Impact of a basal-bolus insulin regimen on metabolic control and risk of hypoglycemia in patients with diabetes undergoing peritoneal dialysis

Gómez Gómez, Ana María; Vallejo, Santiago; Ardila, Freddy; Muñoz Velandia, Oscar Mauricio; Ruiz Morales, Alvaro De Jesús; Sanabria, Mauricio; Bunch, Alfonso; Morros González, Elly Alejandra; Kattah Martinez, Laura Ximena; García Jaramillo, Maira; León Vargas, Fabián

dc.contributor	Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
dc.contributor	Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Grupo de Investigación de Enfermedades Crónicas del Adulto
dc.creator	Gómez Gómez, Ana María
dc.creator	Vallejo, Santiago
dc.creator	Ardila, Freddy
dc.creator	Muñoz Velandia, Oscar Mauricio
dc.creator	Ruiz Morales, Alvaro De Jesús
dc.creator	Sanabria, Mauricio
dc.creator	Bunch, Alfonso
dc.creator	Morros González, Elly Alejandra
dc.creator	Kattah Martinez, Laura Ximena
dc.creator	García Jaramillo, Maira
dc.creator	León Vargas, Fabián
dc.date	2020-03-25T21:03:02Z
dc.date	2020-04-15T13:26:46Z
dc.date	2020-03-25T21:03:02Z
dc.date	2020-04-15T13:26:46Z
dc.date	2018
dc.date.accessioned	2025-10-30T13:46:22Z
dc.date.available	2025-10-30T13:46:22Z
dc.identifier	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5761986/
dc.identifier	19323107 / 19322968 (Electrónico)
dc.identifier	http://hdl.handle.net/10554/47829
dc.identifier	https://doi.org/10.1177/1932296817730376
dc.identifier.uri	http://test.repositoriodigital.com:8080/handle/123456789/187774
dc.description	Q1
dc.description	Artículo original
dc.description	129-135
dc.description	Pacientes con diabetes
dc.description	Introduction: Clinical interventional studies in diabetes mellitus usually exclude patients undergoing peritoneal dialysis (PD). This study evaluates the impact of an educational program and a basal-bolus insulin regimen on the blood glucose level control and risk of hypoglycemia in this population. Methods: A before-and-after study was conducted in type 1 and type 2 DM patients undergoing PD at the Renal Therapy Services (RTS) clinic network, Bogota, Colombia. An intervention was instituted consisting of a three-month educational program and a basal-bolus detemir (Levemir, NovoNordisk) and aspart (Novorapid, NovoNordisk) insulin regimen. Prior to the intervention and at the end of treatment were conducted measures of HbA1c levels and continuous glucose monitoring (CGM). Results: Forty-seven patients were recruited. Mean HbA1c level decreased from 8.41% ± 0.83 to 7.68% ± 1.32 (mean difference –0.739, 95% CI –0.419, –1.059; P < .0001). Of subjects, 52% achieved HbA1c levels <7.5% at the end of study. Mean blood glucose level reduced from 194.0 ± 42.5 to 172.9 ± 31.8 mg/dl (P = .0015) measured by CGM. Significant differences were not observed in incidence of overall (P = .7739), diurnal (P = .3701), or nocturnal (P = .5724) hypoglycemia episodes nor in area under the curve (AUC) <54 mg/dl (P = .9528), but a reduction in AUC >180 (P < .01) and AUC >250 (P = .01) was evidenced for total, diurnal, and nocturnal episodes. Conclusions: An intervention consisting of an educational program and a basal-bolus insulin regimen in type 1 and type 2 diabetes mellitus patients undergoing PD caused a decrease in HbA1c levels, and mean blood glucose levels as measured from CGM with no significant increases in hypoglycemia episodes.
dc.format	PDF
dc.format	application/pdf
dc.format	Papel / Electrónico
dc.format	application/pdf
dc.language	spa
dc.rights	Atribución-NoComercial 4.0 Internacional
dc.rights	http://creativecommons.org/licenses/by-nc/4.0/
dc.source	Journal of Diabetes Science and Technology; Vol. 12 Núm. 1 (2018)
dc.subject	Diabetes mellitus type 1
dc.subject	Diabetes mellitus type 2
dc.subject	Peritoneal dialysis
dc.subject	Hypoglycemia
dc.subject	Insulin
dc.title	Impact of a basal-bolus insulin regimen on metabolic control and risk of hypoglycemia in patients with diabetes undergoing peritoneal dialysis
dc.title	Impact of a basal-bolus insulin regimen on metabolic control and risk of hypoglycemia in patients with diabetes undergoing peritoneal dialysis
dc.type	info:eu-repo/semantics/article
dc.type	http://purl.org/coar/version/c_ab4af688f83e57aa
dc.type	Artículo de revista
dc.coverage	Colombia
dc.coverage	Bogotá (Colombia)

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