Budi Suprapti, Agung Pranoto, Ardian Avrilena Mp., Sumarno, Samirah, Wenny Putri Nilamsari
Objectives: This study was done to compare the effect of RHI 15 minutes before meal and glulisine insulin on blood glucose (BG) achievement and frequency of hypoglycemia in hospitalized Diabetic Nephropathy (DN) patients with hyperglycemia.
Method: Subjects were hospitalized DN patient with inclusion criteria: man/woman with DN stage 3-5 with or without hemodyalisis, 18-65 year old, BMI 18-35 kg/m2, glucose concentration within 200-400 mg/dl, provide written informed consent. Subject randomly divided into RHI and glulisine group. RHI was given 15 minutes before meal and glulisine insulin given 2 minutes before meal. Every subject was examined for preprandial BG (morning, afternoon, and night), 2 hour postprandial BG (morning, afternoon, and night) and bedtime BG concentration for three sequential observation, 24 hours each. Analysis BG data was done to see BG target achievement based on American Diabetes Association (ADA) target.
Result: From the total samples 30 patients (RHI: n = 15; insulin glulisine: n = 15) the results showed that on 1st observation, preprandial, 2 hour post prandial, and bedtime BG had not reached ADA target. However, on the 2nd and 3rd observation, 2hpp blood glucose of both group had reached ADA target, but preprandial and bedtime still had not reached ADA target, the achievement less than 50% patients. The target achievement of preprandial, 2hPP and bedtime BG between RHI and glulisine insulin group was not significantly different. During study, there was no incidence or risk of hypoglycemia in both groups.
Conclusion: There was not significantly different in preprandial, 2hPP and bedtime glucose achievement between group RHI 15 minutes before meal and group glulisine insulin.There was no incidence or risk of hypoglycemia in both groups.