Comparison of the Efficacy and Safety of Insulin Detemir and Insulin Glargine in Hospitalized Patients with Type 2 Diabetes: A Randomized Crossover Trial

Abstract

When both basal insulin analogs were given once daily in T2D, insulin detemir achieved similar efficacy to insulin glargine. On the other hand, there may be differences in action of the compared basal insulins. Further studies with larger patient samples are necessary to support evidence and reveal possible mechanisms.

Comparison of Efficacy and Safety of Glargine and Detemir Insulin in the Management of Inpatient Hyperglycemia and Diabetes

“…Based on these studies, the use of basal insulin analogs -glargine and detemir- has become the preferred insulin formulations in the hospital setting. Two studies have compared treatment with glargine and detemir in the management of hospital hyperglycemia in general medicine and surgery patients with type 2 diabetes (20, 21). Zhang et al (20) conducted a short crossover study in 42 patients with type 2 diabetes treated with detemir and glargine insulin.…”

“…Two studies have compared treatment with glargine and detemir in the management of hospital hyperglycemia in general medicine and surgery patients with type 2 diabetes (20, 21). Zhang et al (20) conducted a short crossover study in 42 patients with type 2 diabetes treated with detemir and glargine insulin. There were no differences in the number of days to achieve target BG (4.0 ± 0.5 days vs. 3.3 ± 0.4 days, p = 0.286) or in total daily insulin dose (30.1 ± 2.4 U vs. 30.1 ± 2.9 U, p = 0.99) between insulin detemir and insulin glargine.…”

“…Studies in ambulatory patients have consistently reported similar improvement in glycosylated hemoglobin (HbA1c) and fasting plasma glucose with these two basal insulin analogs (16, 17, 19), with some studies reporting higher daily insulin requirements in patients treated with detemir insulin (18, 19). Despite the extensive data from ambulatory studies, few studies have compared the efficacy of glargine and detemir insulin in the hospital setting (20, 21). Accordingly, this study aimed to compare the efficacy and safety of the two most commonly used basal insulin formulations in the management of inpatient hyperglycemia and diabetes in non-ICU settings.…”

Real-world experience of using basal insulin analogues in children with type 1 diabetes: is twice-daily dosing of insulin detemir justified?

“…There are a limited number of studies on head-to-head comparison of iDet and iGla in patients with T1D [4,5]. All the comparison studies conducted on patients with either T1D or type 2 diabetes (T2D) also used once-daily dosing of these two basal insulin analogues and demonstrated similar efficacy [5][6][7]. In the only available trial that compared once-versus twice-daily iDet in patients with T1D, the HbA1c at four months was 8.1 ±0.9 vs. 8.0 ±1.0% with once-and twice-daily iDet, respectively, with an adjusted between-group difference of 0.12%, showing noninferiority for once-daily dosing [8].…”

Insulin Detemir Use Is Associated With Higher Occurrence of Hypoglycemia in Hospitalized Patients With Hypoalbuminemia

“…There are no human studies on pharmacokinetics or outcomes of using detemir in hypoalbuminemic patients. Randomized controlled studies of detemir versus glargine have not found a difference in hypoglycemia (6)(7)(8)(9), but these trials included only a few hundred patients who probably were not hypoalbuminemic. A recent retrospective study found a higher rate of hypoglycemia (,70 mg/dL) in determir-treated compared to glargine-treated inpatients (10).…”