Comparison of two insulin injection methods on control of type ۲ diabetes; is the new protocol effective or not?

Introduction: Type ۲ diabetes is a progressive disease with a significant risk for developing late complications.Objectives: This study aimed to determine if the proportion of NPH to regular in day of discharge is similar to first day of admission or not. In other words, we aimed to compare two insulin injection methods on the control of type ۲ diabetes.Patients and Methods: This cross-sectional study was performed on hospital records of type II diabetic patients admitted for insulin therapy with the conventional protocol from ۲۰۰۸-۲۰۱۳. Treatment was initiated with the following proportions; morning NPH: ۴۴%, morning regular dosage: ۲۲%, evening NPH dosage: ۱۷% and evening regular dosage: ۱۷%. Insulin doses of the discharge day in which optimal glycemic control has been achieved were recorded and based on their mean, a protocol was made. Finally, two groups were categorized. Group ۱ consisted of patients whose discharge insulin dose was in the range of the mean data of the study (±۲ IU/mL) and patients whose discharge insulin dose was in accordance with the conventional protocol (±۲ IU/mL) participated in group ۲.Results: At discharge day, the mean morning NPH dose was ۳۴.۲ ± ۶.۶۹, morning regular: ۲۳.۸ ± ۶.۳۶, evening NPH: ۲۱.۲۶±۶.۷۵ and evening regular: ۲۰.۷۴ ± ۵.۵۱. The discharge insulin ratios of the conventional protocol were similar to that of the admission ratios in only ۱۷.۷% of the patients. Only ۳۴.۵% of the patients could include in the new protocol and ۵۰% of them did not fit any protocol.Conclusion: It is suggested to inject one-third of the total daily insulin need as NPH in the morning and divide the remained two-thirds between morning regular, evening NPH and evening regular equally. This may decrease the length of hospital stay and decrease the time to reach the desired glycemic control.

کلیدواژه ها:

Type ۲ diabetes ، Regular insulin ، Conventional protocol