Abstract AP-01
IMPROVE GLYCEMIC CONTROL IN PATIENTS WITH TYPE 2 DIABETES HARN-SHEN CHEN Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taiwan, R.O.C.
The U.K. Prospective Diabetes Study demonstrated that good glycemic control in type 2 diabetes is associated with a reduced risk of diabetes complications. However, achieving and maintaining tight glycemic targets represent a major challenge, especially in insulin treated patients. We first demonstrated an influence of winter holiday on the glycemic control of patients who had type 2 diabetes. Then, we designed a study to investigate whether the effects of regular diabetes health education or a holiday-specific paper pamphlet before the Chinese New Year’s holidays could improve glycemic control during the winter holidays among type 2 diabetics. Self-monitoring blood glucose (SMBG) is important for patients treated with insulin to guide patients toward reaching blood glucose goal. We designed a study to improve glycemic control by a structured education package for SMBG in poorly-controlled type 2 diabetic subjects. This study reveals that a constructed education package for SMBG could improve glycemic control in type 2 diabetic subjects. We designed another pilot study to evaluate the kinetics of HbA1c levels in response to blood glucose change in type 2 diabetic patients with chronic kidney disease. We wanted the HbA1c to be able to decrease about 1.5 to 2.0% in order to see the kinetic change of HbA1c. When a patient presents with new-onset type 2 diabetes with severe hyperglycemia, the optimal treatment is aggressive insulin therapy. We designed an interventional trial to compare the effects of a further 6-month insulin therapy and oral anti-diabetic drugs on long-term glycemic control. Our main finding is that A 6-month course of insulin therapy could more effectively achieve adequate glycemic control and significant improvement of beta-cell function. A 6-month course of insulin therapy led to better 5 year glycemic control than did oral antidiabetic agent therapy in these patients. We provide health education, diabetes management, adjust insulin dose from SMBG, and encourage early insulin therapy to improve glycemic control in patients with type 2 diabetes. These serial studies not only proof some concepts but also translate these results to clinical practice.
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