Overbasalization and glycemic control: longitudinal analysis in people with type 2 diabetes in Peru.

IF 2.1 Q4 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes and Metabolic Disorders Pub Date : 2025-10-15 eCollection Date: 2025-12-01 DOI:10.1007/s40200-025-01756-9

Sandra Analí Vadillo-Saravia, Antonio Bernabé-Ortiz, Antonio Bernabe-Ortiz, Cayetano Heredia

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引用次数: 0

Abstract

Objectives: This study aimed to evaluate the longitudinal association between overbasalization and glycemic control.

Methods: Retrospective cohort study including subjects with T2DM diagnosis, insulin users and treated in the Endocrinology Service of EsSalud through the National Telemedicine Center, part of the Social Security (EsSalud) in Lima, Peru. Data was taken from January 2023 to December 2024, and only those with at least two assessments were considered. Hospitalized participants, chronic users of corticosteroids, those with transfusions, and pregnant women during the study period were excluded. The dependent variable was glycemic control, defined using glycated hemoglobin (HbA1c < 53 mmol/mol [< 7%] or ≥ 53mmol/mol [≥ 7%]), while the independent variable was overbasalization, defined as a basal insulin dose > 0.5 IU/Kg/day. The association of interest was evaluated cross-sectionally and longitudinally.

Results: A total of 398 records, mean age of 63.8 (SD: 10.4) years and 50.8% women, was analyzed. The mean duration of diabetes was 15.8 (SD: 8.7) years, whereas the median duration of insulin use was 3.3 (interquartile range: 6) years. The prevalence of overbasalization at the cohort baseline was 43.4%, whereas only 14.5% had appropriate glycemic control. In cross-sectional analysis, no association of overbasalization with glycemic control was found; however, in the longitudinal analysis (mean: 9.6 [SD: 3.5] months of follow-up), the group with overbasalization had a 42% reduction (95% CI: 20% - 58%) in the probability of having appropriate glycemic control.

Conclusions: Among insulin users, overbasalization was observed to be associated with reduced glycemic control and higher HbA1c levels. More than 40% of insulin users had overbasalization at the cohort baseline. Our study suggests that overbasalization is frequent among people using insulin and should be evaluated to optimize glycemic control.

Supplementary information: The online version contains supplementary material available at 10.1007/s40200-025-01756-9.

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过度碱化和血糖控制：秘鲁2型糖尿病患者的纵向分析。

目的：本研究旨在评估过度碱化与血糖控制之间的纵向关联。方法：回顾性队列研究包括T2DM患者，胰岛素使用者，并通过国家远程医疗中心在秘鲁利马社会保障（EsSalud）的EsSalud内分泌科接受治疗。数据取自2023年1月至2024年12月，只考虑了至少两次评估的数据。住院参与者、长期使用皮质类固醇者、输血者和研究期间的孕妇被排除在外。因变量是血糖控制，用糖化血红蛋白（HbA1c 0.5 IU/Kg/天）来定义。对相关性进行横断面和纵向评估。结果：共分析398例患者，平均年龄63.8岁（SD: 10.4）岁，其中女性50.8%。糖尿病的平均持续时间为15.8年（标准差：8.7），而胰岛素使用的中位持续时间为3.3年（四分位数间距：6）。在队列基线时，过度碱化的患病率为43.4%，而只有14.5%的人有适当的血糖控制。在横断面分析中，没有发现过碱化与血糖控制的关联；然而，在纵向分析（平均：9.6 [SD: 3.5]个月的随访）中，过度碱化组在适当控制血糖的可能性方面降低了42% （95% CI: 20% - 58%）。结论：在胰岛素使用者中，观察到过度碱化与血糖控制降低和HbA1c水平升高有关。超过40%的胰岛素使用者在队列基线时存在过基线化。我们的研究表明，过度碱性化在使用胰岛素的人群中很常见，应该进行评估以优化血糖控制。补充资料：在线版本提供补充资料，网址为10.1007/s40200-025-01756-9。

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来源期刊

Journal of Diabetes and Metabolic Disorders Medicine-Internal Medicine

CiteScore

4.80

自引率

3.60%

发文量

210

期刊介绍： Journal of Diabetes & Metabolic Disorders is a peer reviewed journal which publishes original clinical and translational articles and reviews in the field of endocrinology and provides a forum of debate of the highest quality on these issues. Topics of interest include, but are not limited to, diabetes, lipid disorders, metabolic disorders, osteoporosis, interdisciplinary practices in endocrinology, cardiovascular and metabolic risk, aging research, obesity, traditional medicine, pychosomatic research, behavioral medicine, ethics and evidence-based practices.As of Jan 2018 the journal is published by Springer as a hybrid journal with no article processing charges. All articles published before 2018 are available free of charge on springerlink.Unofficial 2017 2-year Impact Factor: 1.816.