Adjust to target in type 2 diabetes

Comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine

Richard M. Bergenstal, Mary Johnson, Margaret A. Powers, Alan Wynne, Aleksandra Vlajnic, Priscilla Hollander, Marc Rendell

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

OBJECTIVE - Carbohydrate counting is an effective approach to mealtime insulin adjustment in type 1 diabetes but has not been rigorously assessed in type 2 diabetes. We sought to compare an insulin-to-carbohydrate ratio with a simple algorithm for adjusting the dose of prandial insulin glusiline. RESEARCH AND DESIGN METHODS - This 24-week, multicenter, randomized, controlled study compared two algorithms for adjusting mealtime (glulisine) insulin along with a standard algorithm for adjusting background (glargine) insulin in 273 intent-to-treat patients with type 2 diabetes. Glulisine and glargine were adjusted weekly in both groups based on self-monitored blood glucose (SMBG) results from the previous week. The simple algorithm group was provided set doses of glulisine to take before each meal. The carbohydrate counting (carb count) group was provided an insulin-to-carbohydrate ratio to use for each meal and adjusted their glulisine dose based on the amount of carbohydrate consumed. RESULTS - A1C levels at week 24 were 6.70% (simple algorithm) and 6.54% (carb count). The respective mean A1C changes from baseline to 24 weeks were -1.46 and -1.59% (P = 0.24). A1C

Original languageEnglish
Pages (from-to)1305-1310
Number of pages6
JournalDiabetes Care
Volume31
Issue number7
DOIs
StatePublished - Jul 2008

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Type 2 Diabetes Mellitus
Meals
Carbohydrates
Insulin
Type 1 Diabetes Mellitus
Blood Glucose
insulin glulisine
Research Design
Insulin Glargine

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Bergenstal, R. M., Johnson, M., Powers, M. A., Wynne, A., Vlajnic, A., Hollander, P., & Rendell, M. (2008). Adjust to target in type 2 diabetes: Comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. Diabetes Care, 31(7), 1305-1310. https://doi.org/10.2337/dc07-2137

Adjust to target in type 2 diabetes : Comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. / Bergenstal, Richard M.; Johnson, Mary; Powers, Margaret A.; Wynne, Alan; Vlajnic, Aleksandra; Hollander, Priscilla; Rendell, Marc.

In: Diabetes Care, Vol. 31, No. 7, 07.2008, p. 1305-1310.

Research output: Contribution to journalArticle

Bergenstal, RM, Johnson, M, Powers, MA, Wynne, A, Vlajnic, A, Hollander, P & Rendell, M 2008, 'Adjust to target in type 2 diabetes: Comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine', Diabetes Care, vol. 31, no. 7, pp. 1305-1310. https://doi.org/10.2337/dc07-2137
Bergenstal, Richard M. ; Johnson, Mary ; Powers, Margaret A. ; Wynne, Alan ; Vlajnic, Aleksandra ; Hollander, Priscilla ; Rendell, Marc. / Adjust to target in type 2 diabetes : Comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. In: Diabetes Care. 2008 ; Vol. 31, No. 7. pp. 1305-1310.
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