Studies comparing the use of basal bolus with insulin analogs vs. split-mixed regimens with human... more Studies comparing the use of basal bolus with insulin analogs vs. split-mixed regimens with human insulins in hospitalized patients with type 2 diabetes are lacking. In a controlled multicenter trial, we randomized 130 nonsurgical patients with blood glucose (BG) between 140 and 400 mg/dl to receive detemir once daily and aspart before meals (n = 67) or neutral protamine Hagedorn (NPH) and regular insulin twice daily (n = 63). Insulin dose was started at 0.4 U/kg.d for BG between 140 and 200 mg/dl or 0.5 U/kg.d for BG 201-400 mg/dl. Major study outcomes included differences in mean daily BG levels and frequency of hypoglycemic events between treatment groups. Glycemic control improved similarly in both groups from a mean daily BG of 228 +/- 54 and 223 +/- 58 mg/dl (P = 0.61) to a mean daily BG level after the first day of 160 +/- 38 and 158 +/- 51 mg/dl in the detemir/aspart and NPH/regular insulin groups, respectively (P = 0.80). A BG target below 140 mg/dl before meals was achieved in 45% of patients in the detemir/aspart group and 48% in the NPH/regular group (P = 0.86). During treatment, 22 patients (32.8%) in the detemir/aspart group and 16 patients (25.4%) in the NPH/regular group had at least one episode of hypoglycemia (BG < 60 mg/dl) during the hospital stay (P = 0.34). Treatment with basal/bolus regimen with detemir once daily and aspart before meals results in equivalent glycemic control and no differences in the frequency of hypoglycemia compared to a split-mixed regimen of NPH and regular insulin in patients with type 2 diabetes.
Llámase Estado Moderno al Estado Burgués, ese que se diseñó y construyó en la segunda mitad del S... more Llámase Estado Moderno al Estado Burgués, ese que se diseñó y construyó en la segunda mitad del Siglo 18, con los aportes conceptuales y teóricos de ideólogos como Bodino con "Los Seis Libros de la Republica, Grocio con "El Derecho a la Guerra y a la Paz", Altusio con "Política, Hobbes con "El Leviatán", Locke con "Ensayo Sobre el Gobierno Civil, Rousseau con "El Contrato Social, Montesquieu con "El Espíritu de las Leyes" y demás procesos intelectuales que ocurrieron después de la separación de la Iglesia y del Estado al finalizar la guerra de los 30 años en la Paz de Westfalia.
Studies comparing the use of basal bolus with insulin analogs vs. split-mixed regimens with human... more Studies comparing the use of basal bolus with insulin analogs vs. split-mixed regimens with human insulins in hospitalized patients with type 2 diabetes are lacking. In a controlled multicenter trial, we randomized 130 nonsurgical patients with blood glucose (BG) between 140 and 400 mg/dl to receive detemir once daily and aspart before meals (n = 67) or neutral protamine Hagedorn (NPH) and regular insulin twice daily (n = 63). Insulin dose was started at 0.4 U/kg.d for BG between 140 and 200 mg/dl or 0.5 U/kg.d for BG 201-400 mg/dl. Major study outcomes included differences in mean daily BG levels and frequency of hypoglycemic events between treatment groups. Glycemic control improved similarly in both groups from a mean daily BG of 228 +/- 54 and 223 +/- 58 mg/dl (P = 0.61) to a mean daily BG level after the first day of 160 +/- 38 and 158 +/- 51 mg/dl in the detemir/aspart and NPH/regular insulin groups, respectively (P = 0.80). A BG target below 140 mg/dl before meals was achieved in 45% of patients in the detemir/aspart group and 48% in the NPH/regular group (P = 0.86). During treatment, 22 patients (32.8%) in the detemir/aspart group and 16 patients (25.4%) in the NPH/regular group had at least one episode of hypoglycemia (BG < 60 mg/dl) during the hospital stay (P = 0.34). Treatment with basal/bolus regimen with detemir once daily and aspart before meals results in equivalent glycemic control and no differences in the frequency of hypoglycemia compared to a split-mixed regimen of NPH and regular insulin in patients with type 2 diabetes.
Llámase Estado Moderno al Estado Burgués, ese que se diseñó y construyó en la segunda mitad del S... more Llámase Estado Moderno al Estado Burgués, ese que se diseñó y construyó en la segunda mitad del Siglo 18, con los aportes conceptuales y teóricos de ideólogos como Bodino con "Los Seis Libros de la Republica, Grocio con "El Derecho a la Guerra y a la Paz", Altusio con "Política, Hobbes con "El Leviatán", Locke con "Ensayo Sobre el Gobierno Civil, Rousseau con "El Contrato Social, Montesquieu con "El Espíritu de las Leyes" y demás procesos intelectuales que ocurrieron después de la separación de la Iglesia y del Estado al finalizar la guerra de los 30 años en la Paz de Westfalia.
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