Basal Supplementation of Insulin Lispro Protamine Suspension Versus Insulin Glargine and Detemir for Type 2 Diabetes

Abstract

OBJECTIVEWe compared the effect of insulin lispro protamine suspension (ILPS) with that of insulin glargine and insulin detemir, all given as basal supplementation, in the treatment of patients with type 2 diabetes.RESEARCH DESIGN AND METHODSWe conducted an electronic search until February 2012, including online registries of ongoing trials and abstract books. All randomized controlled trials comparing ILPS with insulin glargine or detemir with a duration of ≥12 weeks were included.RESULTSWe found four trials lasting 24–36 weeks involving 1,336 persons: three studies compared ILPS with glargine, and one trial compared ILPS with detemir. There was no significant difference in change in HbA1c level between ILPS and comparators, in the proportion of patients achieving the HbA1c goals of ≤6.5 or <7%, in weight change, or in daily insulin doses. There was no difference in overall hypoglycemia, but nocturnal hypoglycemia occurred significantly more with ILPS than with comparator insulins (mean difference 0.099 events/patient/30 days [95% CI 0.03–0.17]). In a prespecified sensitivity analysis comparing data obtained in patients who remained on their once-daily insulin regimen, not significantly different event rates for nocturnal hypoglycemia were observed between ILPS and comparator insulins (0.063 [−0.007 to 0.13]), and ILPS was associated with lower insulin dose (0.07 units/kg/day [0.05–0.09]).CONCLUSIONSThere is no difference between ILPS and insulin glargine or detemir for targeting hyperglycemia, but nocturnal hypoglycemia occurred more frequently with ILPS than with comparator insulins. Nocturnal hypoglycemia was not significantly different in people who injected insulin once daily.

Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus

“…IGlar has favorable pharmacokinetic and pharmacodynamics properties that allow providing constant insulin activity over 24 h with only a single injection, and is the most widely prescribed LAA [ 12 ]. Since numerous systematic reviews have been published in order to combine the outcomes of many RCTs comparing IGlar with various comparators, the additional value of our meta-analysis will be hereby discussed [ 16 – 34 , 70 ]. Firstly, majority o earlier meta-analyses and secondary studies did not provide a full picture of clinical efficacy and safety of IGlar, since they were focused exclusively on certain aspects of insulin therapy (for example, intensive insulin treatment) [ 16 , 17 , 31 ].…”

“…So far, several attempts have been undertaken to provide reliable summary of data comparing IGlar with other therapeutic options in T2DM patients [ 16 – 34 ]. However, available systematic reviews have assessed only selected insulin preparations and do not provide a broad clinical picture or comprehensive answer, whether IGlar use is associated with additional clinical benefits to a wide spectrum of T2DM patients.…”

Real-world outcomes of US employees with type 2 diabetes mellitus treated with insulin glargine or neutral protamine Hagedorn insulin: a comparative retrospective database study

“…19 Other insulin therapy options, such as insulin detemir and insulin lispro protamine suspension, also have convenience and outcome benefits which may contribute to improved persistence and adherence. [20][21][22] In reality, patients taking insulin glargine have been shown to be more likely to persist with their medication than those taking NPH insulin. 23 In general, treatment complexity for chronic conditionsincluding, though not limited to the need to administer more than one injection daily-correlates with poor adherence.…”

Hubungan Emotional Intelligence Terhadap Kualitas Hidup Pasien Diabetes Mellitus Tipe Ii Di Puskesmas Guguak Panjang Tahun 2018

“…Diabetes melitus atau DM adalah penyakit yang ditandai dengan tingginya kadar gula (hiperglikemia) dalam darah akibat terganggunya metabolisme karena produksi dan fungsi hormon insulin tidak berjalan dengan seharusnya (Syamsiah, 2017). Diabetes melitus disebut juga dengan the silent killer karena penyakit ini dapat mengenai semua organ tubuh (Fatimah, 2015). Beberapa faktor risiko yang dapat menyebabkan timbulnya penyakit diabetesmellitus yakni faktor etnik, umur, riwayat keluarga, riwayat diabetes gestasional, obesitas, stress, diet tidak sehat, kurang aktifitas fisik, dan hipertensi (World Health Organization, 2015).…”