Objective: To explore the insulin requirement profiles and analyze the related factors of type 2 diabetics on insulin pump therapy.
Methods: A total of 296 patients were admitted to hospital for 1-2 weeks of insulin pump therapy and received a diet of 25-30 kcal/kg ideal body weight per day. Insulin infusion was adjusted to achieve normoglycemia. It was defined as fasting capillary blood glucose of no more than 7.0 mmol/L and capillary blood glucose at 2 hours after each of three meals of no more than 10.0 mmol/L. After goal-reaching for 3 days, the insulin requirement profiles and related factors were analyzed.
Results: The average time of achieving normoglycemia was (5.1 ± 2.9) days. The total daily insulin dose per kilogram was (0.80 ± 0.27) U/kg and the ratio of total basal insulin dose to total bolus insulin dose 40%: 60%. Patients with central obesity needed a higher ratio of total basal insulin dose to total daily insulin dose (P < 0.05). Associations existed between the ratio of total basal insulin dose to total daily insulin dose and disease duration, waist circumference and ratio of 2 hour-postprandial C-peptide to fasting C-peptide (r = 0.169, 0.143, -0.107, all P < 0.05). Multivariate linear regression analyses showed that waist circumference, disease duration and ratio of 2 hour-postprandial C-peptide to fasting C-peptide were independently related with the ratio of total basal insulin dose to total daily insulin dose. Also waist circumference, fasting plasma glucose and hemoglobin A1c levels were independently associated with total daily insulin dose per kilogram.
Conclusion: The ratio of total basal insulin dose to total bolus insulin dose is 40%: 60% in Chinese type 2 diabetics with insulin pump therapy. And it is associated with central obesity level and β-cell function. Parameters indicating glycemic control and central obesity should be taken into consideration for total insulin requirements.