Insulin variants and glycemic control in individuals with diabetes under insulin therapy in Ulaanbaatar

Abstract

Background: The discovery of insulin over a century ago revolutionized diabetes care, but achieving optimal glycemic control remains challenging, influenced by various factors, including insulin type. While developed countries have shifted from recombinant to analog insulin, research on insulin types and glycemic control in our country is lacking. Aim: This study aims to investigate the relationship between insulin type and glycemic control in individuals with diabetes. Materials and Methods: Employing a hospital-based cross-sectional design, we surveyed 280 individuals (aged 1865) with insulin use across six districts of Ulaanbaatar. Two groups responded to a 44-question questionnaire, and body measurements were recorded. Statistical analysis utilized the SPSS-25, considering at p<0.05 as statistically significant. Results: Subjects had a mean age of 54.3±12.9, with 46.8% males. Diabetes duration was 12.6±6.33 years, and insulin treatment duration was 5.37±5.15 years. Notably, 85% used recombinant insulin, while only 15% used analog insulin. Overall, mean HbA1C was 11.0±2.80, indicating poor control in 90.4%. Although no significant differences were observed in glycemic control indicators, individuals using analog insulin exhibited lower glycated hemoglobin (10.7±2.15), suggesting better control. Regarding insulin therapy adherence, 27.0% missed doses, interrupted their regimen, or reduced insulin doses. Conclusions: 1. In Mongolia, only 15% of individuals with diabetes on insulin treatment use analog insulin. 2. A significant majority (90.4%) exhibit poor glycemic control, and 27% do not adhere to insulin therapy.