| Topic: | Diabetes (DM) |
| Title: | Basal Insulin Therapy in Type 2 Diabetes: 28-Week Comparison of Insulin Glargine (HOE 901) and NPH Insulin. |
| Author: | Rosenstock, J., et al. |
| Source: | Diabetes Care. 24(4): 631-636. April 2001. |
| Availability: | Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. |
| Abstract: | This review article describes a study that determined the safety and efficacy of the long acting analog insulin glargine compared with NPH insulin in patients with type 2 diabetes who were not taking oral agents and who had previously been treated with insulin alone. The study population consisted of 518 people with type 2 diabetes who were receiving NPH insulin with or without regular insulin for postprandial control. Of these, 259 were randomized to receive insulin glargine once daily, and the remaining 259 received NPH insulin once or twice daily for 28 weeks in an open label, multicenter trial. Doses were adjusted to obtain target fasting glucose less than 6.7 mmol per liter. At study endpoint, the median total daily insulin dose in both treatment groups was 0.75 IU per kilogram. The study found that the treatment groups showed similar improvements in glycosylated hemoglobin (HbA1c) from baseline to endpoint on intent to treat analysis. The mean change in HbA1c from baseline to endpoint was similar in the insulin glargine group and the NPH group after patients began with an average baseline HbA1c of approximately 8.5 percent. The treatments were associated with similar reductions in fasting glucose levels. Overall, mild symptomatic hypoglycemia was similar in insulin glargine subjects and NPH insulin subjects. However, nocturnal hypoglycemia in the insulin glargine group was reduced by 25 percent during the treatment period after the dose titration phase. Subjects in the insulin glargine group experienced less weight gain than those in the NPH group. The article concludes that, in patients with type 2 diabetes, once daily bedtime insulin glargine is as effective as once or twice daily NPH in improving and maintaining glycemic control. In addition, insulin glargine demonstrates a lower risk of nocturnal hypoglycemia and less weight gain compared with NPH insulin. 1 appendix. 2 figures. 1 table. 18 references. (AA-M). |
| Format: | Journal Article |
| Language: | English. |
| Major Keywords: | Diabetes Mellitus. Type 2 Diabetes. Drug Therapy. Insulin. Product Safety. Drug Effects. |
| Minor Keywords: | Blood Glucose. Glycosylated Hemoglobin. Hypoglycemia. Clinical Research. |
| Publication Number: | DMJA09701 |
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