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Introduction. Correctness of insulin treatment depends on both the experience and skills of the doctor and knowledge and behaviour of the patient. Objective. Evaluation the adequacy of insulin doses administered to diabetes patients in ambulatory conditions. Material and methods. The treatment of 59 patients hospitalized in the Diabetology Ward was evaluated at admission, discharge and 3 months after hospitalization. Results. The mean daily doses of insulin significantly differed at times of evaluation and were: 53.90, 39.31 and 43.34 units, respectively (p≈0.000001). A significant reduction of body weight, 90.86 vs. 88.25 kg (p≈0.000001), was obtained only during hospitalization, and was maintained 3 months after discharge (87.86 kg). Significant differences were also noted in the body mass index (33.44 vs. 32.48 vs. 32.37 kg/m2, p≈0.000001). The change in waist circumference was not statistically significant (107.87 vs. 104.89 cm; p≈0.06). A decrease in the number of hypoglycaemia episodes was observed, but were statistically insignificant (25 vs. 23; p≈0.7). Three months after hospitalization an insignificant decrease of HbA1c level was noted (8.41% vs. 8.03%; p≈0.07). Conclusions. During treatment in the Diabetology Ward the procedure of choice was more frequently a reduction than an increase in insulin doses. This management led to the reduction of the patients’ body weight, improvement of glycaemia, without any significant effect on the diabetes control determined by the HbA1c level.
Introduction and objective: Diabetic patients are at high risk for peripheral arterial disease (PAD) characterized by symptoms of intermittent claudication or critical limb ischemia. Measurement of ankle-brachial index (ABI) has emerged as the diagnostic tool of choice, because it is relatively simple, non-invasive and inexpensive. It is also an independent marker of increased morbidity and mortality from cardiovascular diseases. The aim of the presented study was to assess the relationship between current glycemic control defined by glycated hemoglobin (HbA1c) level, and quantitative changes in the arteries of the lower limbs in patients with type 2 diabetes. Materials and methods: 175 patients with type 2 diabetes hospitalized in the Diabetology Ward were studied. VENO Doppler and a sphygmomanometer were used to assess blood flow. Results: The average level of HbA1c was assessed at 8.48%. Although the average level of ABI indicator was 1.20 (normal), only 45% of evaluated patients had their individual index within the normal range. Signs of ischemia were found in 17.7% of examined subjects. There was no conclusive correlation between ABI and HbA1c levels. Conclusions: The current level of glycemic control evaluated as HbA1c has no direct impact on the advancement of diabetic angiopathy evaluated as ABI.
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