A 16-week comparison of the novel insulin analog insulin glargine (HOE 901) and NPH human insulin used with insulin lispro in patients with type 1 diabetes.

Abstract

RESEARCH DESIGN AND METHODS -Patients with type 1 diabetes receiving basalbolus insulin treatment with NPH human insulin and insulin lispro were randomized to receive insulin glargine (HOE 901), a long-acting basal insulin analog, once a day (n = 310) or NPH human insulin (n = 309) as basal treatment with continued bolus insulin lispro for 16 weeks in an open-label study. NPH insulin patients maintained their prior schedule of administration once or twice a day, whereas insulin glargine patients received basal insulin once a day at bedtime.RESULTS -Compared with all NPH insulin patients, insulin glargine patients had significant decreases in fasting blood glucose measured at home (means ± SEM, Ϫ42.0 ± 4.7 vs. Ϫ12.4 ± 4.7 mg/dl [-2.33 ± 0.26 vs. Ϫ0.69 ± 0.26 mmol/l]; P = 0.0001). These differences were evident early and persisted throughout the study. More patients in the insulin glargine group (29.6%) than in the NPH group (16.8%) reached a target fasting blood glucose of 119 mg/dl (Ͻ6.6 mmol/l). However, there were no differences between the groups with respect to change in GHb. Insulin glargine treatment was also associated with a significant decrease in the variability of fasting blood glucose values (P = 0.0124). No differences in the occurrence of symptomatic hypoglycemia, including nocturnal hypoglycemia, were observed. Overall, adverse events were similar in the two treatment groups with the exception of injection site pain, which was more common in the insulin glargine group (6.1%) than in the NPH group (0.3%). Weight gain was 0.12 kg in insulin glargine patients and 0.54 kg in NPH insulin patients (P = 0.034).CONCLUSIONS -Basal insulin therapy with insulin glargine once a day appears to be as safe and at least as effective as using NPH insulin once or twice a day in maintaining glycemic control in patients with type 1 diabetes receiving basal-bolus insulin treatment with insulin lispro.

Adjust to Target in Type 2 Diabetes

“…Other studies (15,16) have shown that patients whose diabetes is wellcontrolled with insulin often have a basal: bolus insulin ratio close to 50%:50%. At week 24, after multiple weekly titrations of insulin based on SMBG patterns, both the simple algorithm and the carb count groups had basal-bolus insulin ratios of ϳ49%:51%.…”

Evaluation of Safety and Efficacy of Glaritus<sup>®</sup> versus Lantus<sup>®</sup> in Combination with Insulin Lispro among Adults with Type 1 Diabetes Mellitus-Phase IV Study

“…A study comparing the effects of insulin glargine with NPH insulin demonstrated that Insulin glargine was associated with significantly greater reductions in FBG than NPH (p = 0.0001) in T1DM patients [30]. Patients who switched from NPH insulin to insulin glargine showed significant improvement in HbA1c levels (p < 0.05) over a period of 3 months [31].…”

Comparação entre a bomba de infusão de insulina subcutânea e o esquema de múltiplas doses de insulina em adolescentes com diabetes melito do tipo 1 da rede pública de saúde na abordagem da hipoglicemia grave

“…Esta indicação é reforçada pela heterogeneidade dos resultados na redução da hipoglicemia grave com a utilização do esquema de múlti-plas doses de insulina (MDI), com os análogos de insulina de ação curta e lenta (10)(11)(12)(13)(14)(15). Esses estudos têm mostrado que a utilização desses análogos reduzem as hipoglicemias leves, moderadas e noturnas, mas não as graves.…”