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Online J Curr Clin Trials. 1995 Dec 15;Doc No 199:[2725 words; 26 paragraphs].

Effect of intensive insulin therapy on abnormal circadian blood pressure pattern in patients with type I diabetes mellitus.

Author information

1
University of California, Division of Endocrinology, Davis, Sacramento 95817, USA.

Abstract

OBJECTIVE:

To assess the effect of tight glycemic control on the abnormal circadian BP pattern associated with IDDM.

DESIGN:

Retrospective, randomized control trial.

SETTING:

Diabetes Research Institute, ambulatory.

PATIENTS:

Seventy-four IDDM patients (22M/52F) on intensive subcutaneous insulin therapy (ISIT) were selected for this study.

INTERVENTIONS:

Group A patients (11M/25F) underwent, in addition to ISIT, weekly chronic intermittent intravenous insulin therapy (CIIIT) (TT Aoki et al, Lancet, 1993, 432:515-8). Group B patients (11M/27F) were continued on ISIT alone. All study patients were followed for 3 months on this regimen. They were seen weekly by the investigators and underwent monthly HbA1c determinations and 24-h ambulatory BP monitoring.

RESULTS:

Glycemic control improved significantly in group A subjects (HbA1c decreased from 7.9% to 7.2%, p = 0.0002) but changed little in the group B subjects (p = NS). The night/day systolic BP ratio decreased from 0.97 to 0.94 (-3.10%) in group A and increased from 0.95 to 0.98 (+3.16%) in group B subjects (p = 0.224). The night/day diastolic ratio decreased from 0.93 to 0.90 (-3.23%) in group A and increased from 0.91 to 0.94 (+3.29%) in group B subjects (p = 0.0037).

CONCLUSIONS:

CIIIT performed in IDDM patients on ISIT further improves their glycemic control and tends to reverse or at least prevent further deterioration of their abnormal circadian BP pattern.

PMID:
8542099
[Indexed for MEDLINE]

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