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Diabetic Medicine

Year: 2011  |  Volume: 28  |  Issue: 2  |  Page No.: 223 - 226

Prevalence of injection-meal interval usage and its association with variables of metabolic control in patients with Type 1 and Type 2 diabetes

N. Muller, C. Kloos, T. Frank, M. Ristow, G. Wolf and U. A. Muller

Abstract

Objective Regular human insulin is usually recommended with an injection-meal interval. It is not known how many patients follow these recommendations and, of those who do, the injection-meal interval remains incompletely studied. We investigated the injection-meal interval in patients with Type 1 and Type 2 diabetes and the association with metabolic control in routine care. Methods Four hundred and seventy-one consecutive patients with Type 1 or Type 2 diabetes were interviewed to determine their injection-meal interval in a university outpatient clinic setting in Germany in 2006. Four hundred and thirty-three interviews were suitable for analysis (143 Type 1 diabetes, 290 Type 2 diabetes). HbA1c was Diabetes Control and Complications Trial adjusted. Results Among those with Type 1 diabetes, 27% ‘always’, 27% ‘sometimes’ and 46% ‘never’ used an injection-meal interval. Forty-three per cent of patients with Type 2 diabetes always used an injection-meal interval, 12% sometimes and 45% never. Among patients with Type 1 diabetes, there was no difference in HbA1c between those who always used an injection-meal interval (n = 39, age 58 years, duration of diabetes 21.1 years, BMI 28.7 kg/m², HbA1c 7.50%/58 mmol/mol) compared with those who never used an injection-meal interval (n = 66, age 47.3 years, duration of diabetes 17.4 years, BMI 27.3 kg/m², HbA1c 7.55%/59 mmol/mol). Among patients with Type 2 diabetes, HbA1c in those who always used an injection-meal interval (n = 124, age 65 years, duration of diabetes 13.8 years, BMI 32.6 kg/m², HbA1c 7.31%/56 mmol/mol) is 0.27% lower compared with those who never used an injection-meal interval (n = 130, age 64.3 years, duration of diabetes 16 years, BMI 32.8 kg/m², HbA1c 7.58%/59 mmol/mol). Conclusion Nearly half of insulin-treated patients do not use an injection-meal interval. We found no significant association between adherence to injection-meal interval and HbA1c in patients with Type 1 diabetes, but a slightly lower HbA1c in patients with Type 2 diabetes who always use an injection-meal interval.

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