[Effectiveness of selected methods of the short-term intensive insulin therapy in patients with poorly controlled type 2 diabetes mellitus].

Poorly controlled type 2 diabetes mellitus can be an indication for hospitalisation and short-term intensive insulin therapy. There are different forms of such therapy i.e. multiple daily injections (MDI), continuous subcutaneous insulin infusion (CSII) or continuous intravenous insulin infusion (IVII). The aim of our study was to compare the efficacy of these methods of intensive insulin therapy. The following parameters were measured: 1) time period needed for "near normoglycaemia" establishment and 2) mean daily glucose values reduction as a result of the treatment applied. 60 patients with poorly controlled type 2 diabetes (daily blood glucose profile values > 250 mg/dl) treated with insulin twice daily were enrolled into the study. Patients were randomly divided into three groups: CSII, IVII and MDI. CSII as realized through subcutaneous insulin pump model MiniMed 508, IVII through intravenous pump model Duet standard 50-Kwapisz and MDI was based on four insulin injections per day in bolus--basal fashion. Intensive insulin therapy was continued until satisfying daily glucose profile achievement (80-180 mg/dl). After "near normoglycaemia" attainment, a conventional insulin therapy was introduced through subcutaneous insulin dosage. Significant reduction of mean daily glucose values as result of applied treatment was observed in all the groups examined. The degree of glycaemia reduction amounted 60 mg/dl for CSII and 85 mg/dl for IVII. There was no statistical significant difference between treated groups. Mean duration of intensive insulin therapy until "near normoglycaemia" establishment was significantly longer in MDI as compared to CSII and IVII groups (6 days vs. 4.45 and 5.2 respectively). Short-term intensive insulin therapy by MDI, CSII and IVII gives good glycemic control and significantly reduces mean daily glucose values, but this aim can be achieved most quickly using CSII and IVII.