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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

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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