J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Original Article

Volume 4, Number 1-2, April 2014, pages 13-24

Outpatient Diabetic Care in a Public Central Hospital: Patient Characteristics, Therapeutic Regimens and Results

Figure 1. Pharmacological regimens in DM1 patients. T: pancreas transplant; CSCII: continuous subcutaneous insulin infusion; IA-INS: intermediate acting insulin; RA-INS: rapid acting insulin; INSMIXT: pre-mixed insulin with intermediate acting insulin and 10, 20 or 30% of rapid acting insulin; M: metformin; P: pioglitazone; A: acarbose; S: sulphonylurea; NT: nateglinide; N: without pharmacological drug therapy. Number of patients with each regimen is presented in the horizontal axis. The most common regime is filled dark gray and the other common regimens are filled light gray.

Figure 2. Pharmacological regimens in DM2-IT patients. T: pancreas transplant; CSCII: continuous subcutaneous insulin infusion; IA-INS: intermediate acting insulin; RA-INS: rapid acting insulin; INSMIXT: pre-mixed insulin with intermediate acting insulin and 10, 20 or 30% of rapid acting insulin; M: metformin; P: pioglitazone; A: acarbose; S: sulphonylurea; NT: nateglinide; N: without pharmacological drug therapy. Number of patients with each regimen is presented in the horizontal axis. The most common regime is filled dark gray and the other common regimens are filled light gray.

Figure 3. Pharmacological regimens in DM2-NIT patients. T: pancreas transplant; CSCII: continuous subcutaneous insulin infusion; IA-INS: intermediate acting insulin; RA-INS: rapid acting insulin; INSMIXT: pre-mixed insulin with intermediate acting insulin and 10, 20 or 30% of rapid acting insulin; M: metformin; P: pioglitazone; A: acarbose; S: sulphonylurea; NT: nateglinide; N: without pharmacological drug therapy. Number of patients with each regimen is presented in the horizontal axis. The most common regime is filled dark gray and the other common regimens are filled light gray.

**Table 1.** Patient Clinical Characteristics
Results are presented as %, or as the mean ± standard deviation and between parenthesis the range.
Gender (M/F) (%)	48/52
Age (years)	55 ± 16 (9 - 85)
Years since diagnosis	11 ± 9 (1 - 41)
BMI (kg/m²)	28.0 ± 5.7 (17.1 - 51.6)
Underweight (BMI < 18 kg/m²) (%)	2
Overweight (25 < BMI < 30 kg/m²) (%)	32
Obesity (BMI > 30 kg/m²) (%)	30
Retinopathy (%)	35
Cataracts (%)	38
Nephropathy (%)	40
Cystopathy (%)	10
Gastroenteropathy (%)	3
Peripheral neuropathy (%)	33
Diabetic foot (%)	3
High blood pressure (%)	56
Dyslipidemia (%)	61
Ischemic heart disease (%)	13
Cerebrovascular disease (%)	3
Peripheral vascular disease (%)	24

Table 1. Patient Clinical Characteristics

Results are presented as %, or as the mean ± standard deviation and between parenthesis the range.

Gender (M/F) (%)

48/52

Age (years)

55 ± 16 (9 - 85)

Years since diagnosis

11 ± 9 (1 - 41)

BMI (kg/m²)

28.0 ± 5.7 (17.1 - 51.6)

Underweight (BMI < 18 kg/m²) (%)

Overweight (25 < BMI < 30 kg/m²) (%)

Obesity (BMI > 30 kg/m²) (%)

Retinopathy (%)

Cataracts (%)

Nephropathy (%)

Cystopathy (%)

Gastroenteropathy (%)

Peripheral neuropathy (%)

Diabetic foot (%)

High blood pressure (%)

Dyslipidemia (%)

Ischemic heart disease (%)

Cerebrovascular disease (%)

Peripheral vascular disease (%)

**Table 2.** Rate of Microvascular Complications Across Diagnostic Categories
	DM1	DM2-IT	DM2-NIT
Retinopathy (%)	33	53	29
Cataracts (%)	6	60	44
Nephropathy (%)	34	59	35
Autonomic cystopathy (%)	5	21	7
Autonomic gastroenteropathy (%)	7	3	3
Peripheral neuropathy (%)	21	40	34
Diabetic foot (%)	1	6	3

Table 2. Rate of Microvascular Complications Across Diagnostic Categories

DM1

DM2-IT

DM2-NIT

Retinopathy (%)

Cataracts (%)

Nephropathy (%)

Autonomic cystopathy (%)

Autonomic gastroenteropathy (%)

Peripheral neuropathy (%)

Diabetic foot (%)

**Table 3.** Rate of Macrovascular Disease Across Diagnostic Categories
	DM1	DM2-IT	DM2-NIT
High blood pressure (%)	21	71	63
Dyslipidemia (%)	50	66	63
Ischemic heart disease (%)	2	16	17
Cerebrovascular disease (%)	0	7	3
Peripheral vascular disease (%)	7	31	27

Table 3. Rate of Macrovascular Disease Across Diagnostic Categories

DM1

DM2-IT

DM2-NIT

High blood pressure (%)

Dyslipidemia (%)

Ischemic heart disease (%)

Cerebrovascular disease (%)

Peripheral vascular disease (%)

**Table 4.** Selected Biochemical Parameters Across Diagnostic Groups
	DM1	DM2-IT	DM2-NIT
VS (mm)	11 ± 9	34 ± 31	13 ± 23
CRP (mg/dL)	0.25 ± 0.47	0.54 ± 0.64	0.43 ± 0.54
Homocysteine (mmol/L)	7 ± 2	12 ± 6	13 ± 5
Fibrinogen (mg/dL)	320 ± 56	369 ± 53	342 ± 135
ACTH (pg/mL)	23 ± 15	23 ± 14	22 ± 12
Cortisol (µg/dL)	19 ± 7	16 ± 8	20 ± 7
Renin (pg/mL)	19 ± 10	27 ± 19	26 ± 34
Aldosterone (pg/mL)	124 ± 117	106 ± 73	106 ± 66
C-peptide (ng/mL)	0.9 ± 0.5	1.9 ± 0.9	2.8 ± 1.3
Cortisol (µg, 24 h urine)	78 ± 39	109 ± 49	91 ± 43
Aldosterone (µg, 24 h urine)	18 ± 20	20 ± 29	14 ± 20
C-peptide (µg, 24 h urine)	15 ± 26	56 ± 59	93 ± 56

Table 4. Selected Biochemical Parameters Across Diagnostic Groups

DM1

DM2-IT

DM2-NIT

VS (mm)

11 ± 9

34 ± 31

13 ± 23

CRP (mg/dL)

0.25 ± 0.47

0.54 ± 0.64

0.43 ± 0.54

Homocysteine (mmol/L)

7 ± 2

12 ± 6

13 ± 5

Fibrinogen (mg/dL)

320 ± 56

369 ± 53

342 ± 135

ACTH (pg/mL)

23 ± 15

23 ± 14

22 ± 12

Cortisol (µg/dL)

19 ± 7

16 ± 8

20 ± 7

Renin (pg/mL)

19 ± 10

27 ± 19

26 ± 34

Aldosterone (pg/mL)

124 ± 117

106 ± 73

106 ± 66

C-peptide (ng/mL)

0.9 ± 0.5

1.9 ± 0.9

2.8 ± 1.3

Cortisol (µg, 24 h urine)

78 ± 39

109 ± 49

91 ± 43

Aldosterone (µg, 24 h urine)

18 ± 20

20 ± 29

14 ± 20

C-peptide (µg, 24 h urine)

15 ± 26

56 ± 59

93 ± 56

**Table 5.** Results of Medical Treatment
	DM1	DM2-IT	DM2-NIT
SBP: systolic blood pressure; DBP: diastolic blood pressure.
HbA1c (%)	7.4 ± 1.6	9.3 ± 2.4	8.6 ± 1.6
HbA1c < 7% (%)	45	8	15
HbA1c < 8% (%)	71	30	34
Δ HbA1c (first-last visit)	0.6 ± 1.7	-0.4 ± 2.3	0.7 ± 1.8
Serum glucose (mg/dL)	157 ± 65	181 ± 93	169 ± 81
Δ weight (kg) (first-last visit)	1 ± 4	-2 ± 7	-2 ± 5
SBP (mmHg)	136 ± 21	117 ± 24	136 ± 16
SBP ≤ 130 mmHg (%)	55	84	53
DBP (mmHg)	73 ± 14	65 ± 13	72 ± 9
DBP ≤ 80 mmHg (%)	84	88	89
Serum cholesterol (mg/dL)	191 ± 42	192 ± 60	195 ± 38
Serum cholesterol ≤ 200 mg/dL (%)	64	75	64
Serum triglycerides (mg/dL)	152 ± 90	114 ± 160	169 ± 96
Serum triglycerides ≤ 150 mg/dL (%)	58	89	51
Serum HDLc (mg/dL)	54 ± 17	66 ± 22	56 ± 26
Serum HDL ≥ 45 mg/dL (%)	63	85	72

Table 5. Results of Medical Treatment

DM1

DM2-IT

DM2-NIT

SBP: systolic blood pressure; DBP: diastolic blood pressure.

HbA1c (%)

7.4 ± 1.6

9.3 ± 2.4

8.6 ± 1.6

HbA1c < 7% (%)

HbA1c < 8% (%)

Δ HbA1c (first-last visit)

0.6 ± 1.7

-0.4 ± 2.3

0.7 ± 1.8

Serum glucose (mg/dL)

157 ± 65

181 ± 93

169 ± 81

Δ weight (kg) (first-last visit)

1 ± 4

-2 ± 7

-2 ± 5

SBP (mmHg)

136 ± 21

117 ± 24

136 ± 16

SBP ≤ 130 mmHg (%)

DBP (mmHg)

73 ± 14

65 ± 13

72 ± 9

DBP ≤ 80 mmHg (%)

Serum cholesterol (mg/dL)

191 ± 42

192 ± 60

195 ± 38

Serum cholesterol ≤ 200 mg/dL (%)

Serum triglycerides (mg/dL)

152 ± 90

114 ± 160

169 ± 96

Serum triglycerides ≤ 150 mg/dL (%)

Serum HDLc (mg/dL)

54 ± 17

66 ± 22

56 ± 26

Serum HDL ≥ 45 mg/dL (%)