Starting insulin therapy in elderly non-insulin-dependent diabetic patients at a health care centre. Methodological and economic aspects

Tovi, Jonas; Furhoff, Anna‐Karin; Lennerhagen, Per; Engfeldt, Peter

doi:10.3109/02813439709018493

Cited by 4 publications

(2 citation statements)

References 18 publications

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“…Our 2% lowering of mean HbA1 values after 1 year of insulin treatment is a greater reduction than that in the UK Prospective Diabetes Study (22). A Swedish study in primary care followed 14 patients with a mean age of 75.5 years who managed insulin therapy and achieved good metabolic control (25). The feasibility of insulin treatment is clearly confirmed in our study and our metabolic results, as well as group characteristics, tend to support recent consensus recommendations about individually-adjusted glycaemic targets together with attempts to reduce cardiovascular risk factors (26).…”

Section: Discussionsupporting

confidence: 84%

Insulin treatment for poorly regulated diabetic patients in general practice: Better regulation and symptom relief?

Johansen¹,

Claudi²,

Holtedahl³

1999

Scandinavian Journal of Primary Health Care

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Section: Discussionsupporting

confidence: 84%

Insulin treatment for poorly regulated diabetic patients in general practice: Better regulation and symptom relief?

Johansen¹,

Claudi²,

Holtedahl³

1999

Scandinavian Journal of Primary Health Care

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“…The patients were randomly divided into two treatment groups. One group was put on insulin (insulin-treated, n = 20) and a district nurse showed them how to monitor the blood-glucose levels regularly and to administer injections (16). Adjustments in doses were made until the blood-glucose reached levels of 6-12 mmol/l during the day.…”

Section: Subjects and Controlsmentioning

confidence: 99%

Diabetic neuropathy in elderly Type 2 diabetic patients: effects of insulin treatment

Tovi

Svanborg

Nilsson

et al. 2009

Acta Neurologica Scandinavica

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Objectives ‐ To study the occurrence of diabetic neuropathy and the effect of insulin treatment in elderly Type 2 diabetic patients. Material and methods ‐In 38 patients and 20 controls symptoms and neurophysiological examinations including electroneurography, vibration perception and temperature discrimination thresholds were investigated. Patients were randomized to insulin (n= 18) or sulfonylurea (n= 16) treatment and were re‐investigated after 1 year. Results ‐ Neuropathy was present in 21/38 patients (56%). It was asymptomatic in 17/38 (45%) and symptomatic in 4/38 (11%). The occurrence of neuropathy was less common in healthy controls, 3/20 (15%) (P<0.01). Temperature discrimination thresholds was the test that most often revealed pathology. The metabolic control after 1 year was significantly improved in the insulin treated group and unchanged in the sulfonylurea treated group. There were no changes as regards occurrence of neuropathy between or within the two treatment groups after 1 year. Conclusion ‐ Diabetic neuropathy is common among elderly Type 2 diabetic patients. It is mostly asymptomatic. Improvement was not seen after 1 year of insulin treatment.

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Well‐being and symptoms in elderly Type 2 diabetes patients with poor metabolic control: Effect of insulin treatment

Tovi

Engfeldt

1998

Pract Diab Int

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The effect of improved metabolic control on well-being and symptoms, with insulin therapy, was investigated in elderly patients with Type 2 diabetes. They had secondary failure on oral therapy, but were without decompensation. A selfadministered well-being questionnaire was used. Patients were randomised to insulin or oral treatment and followed for one year. Initially, diabetic patients (compared with hypertensive controls in the same age group) had significantly lower perception of well-being and more symptoms of tension, depression and pain. After one year, metabolic control improved significantly in the insulintreated group [ HbAIc fell from 9.3 (1.4)% to 7.3 (1. I) % (pcO.OUl)] but not in the sulphonylurea-treated group[HbAlc was 9. I (1.2)% at the start and 9.3 (1.6) % after one year (n.s.d.)]. Improved metabolic control was not associated with improvement in well-being. Insulin therapy, however, reversed symptoms of hyperglycaemia without increasing symptoms of hypoglycaemia and thus seems safe to use in elderly diabeticpatients.Practical Diabetes Int 1 998; 15(3): 73-77

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Starting insulin therapy in elderly non-insulin-dependent diabetic patients at a health care centre. Methodological and economic aspects

Cited by 4 publications

References 18 publications

Insulin treatment for poorly regulated diabetic patients in general practice: Better regulation and symptom relief?

Insulin treatment for poorly regulated diabetic patients in general practice: Better regulation and symptom relief?

Diabetic neuropathy in elderly Type 2 diabetic patients: effects of insulin treatment

Well‐being and symptoms in elderly Type 2 diabetes patients with poor metabolic control: Effect of insulin treatment

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