Effect of Insulin Analogs on the Decline of Hemoglobin in Diabetic Patients with Nephropathy

Hasslacher, C.; Collenberg, E.; Möcks, Joachim

doi:10.1055/s-0029-1241826

Cited by 3 publications

(2 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with normal kidney function also showed slightly higher hemoglobin values with glargine/lispro administration than with HI, and the difference bordered on statistical significance. These results confirm overall the findings of our earlier study in a smaller patient collective and extend them by the identification of two IAs that are essentially responsible for the hemoglobin-stabilizing effect [Hasslacher et al 2010].…”

Section: Discussionsupporting

confidence: 91%

“…Despite its clinical relevance, the relationship between the type of insulin therapy and the onset of diabetic complications has been poorly investigated. In a previous study, we reported IA to be associated with a better kidney function and smaller decrease in hemoglobin concentrations with declining kidney function than HI [Hasslacher et al 2010]. Due to the small number of patients, differentiation considering types of IAs was not possible in this early publication.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function

Hasslacher

Kulozik

Bermejo

2016

Therapeutic Advances in Endocrinology

View full text Add to dashboard Cite

BackgroundInsulin analogs (IAs) are widely used in the treatment of insulin-dependent diabetic patients. Compared with human insulin (HI), short-acting IAs decrease postprandial blood glucose peaks by their faster onset of action. Long-acting IAs decrease the risk of hypoglycemia by their balanced pharmacokinetics. Owing to these effects, IAs do not just improve glycemic control but may also lower the risk of vascular complications. Despite its clinical relevance, the relationship between the type of insulin therapy and the onset Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function Christoph Hasslacher, Felix Kulozik and Justo Lorenzo Bermejo Abstract Objectives: The influence of type of insulin treatment -insulin analogs versus human insulinon the development of diabetes related vascular complications has been sparsely investigated. We examine here possible differences regarding kidney function and hemoglobin levels. Methods: Multiple linear regression was used to investigate the relationship between the following characteristics measured in 509 type 1 diabetic patients who were recruited in an outpatient practice: current clinical status and treatment modalities, type of injected insulin and the routine laboratory parameters hemoglobin, HbA1c, serum creatinine, eGFR, hs CRP and urinary albumin/creatinine ratio. Results: Compared with human insulin, multiple regression analysis taking into account possible confounders revealed that treatment with insulin analogs was associated with increased eGFR (+7.1 ml/min; P=0.0002), lower urinary albumin/creatinine ratio (ratio logarithm -0.4; P=0.003) and higher hemoglobin concentration (+0.31 g/dl; P=0.04). Stratification by type of insulin showed the best renal status for treatment with insulins Glargine and Lispro. Differences were consistent both for patients with normal (eGFR > 90 ml/min) and with an impaired (eGFR < 90 ml/min) kidney function. Conclusions: Present results suggest that treatment of type 1 diabetic patients with normal and impaired renal function with insulin analogs, especially Glargine and Lispro, is associated with better kidney function, lower urinary albumin/creatinine ratio and lower hemoglobin concentration compared to therapy with human insulin. If confirmed by other studies , treatment with insulin analogs may be a further possibility in delaying progression of nephropathy and in preventing early hemoglobin decline.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function

Hasslacher

Kulozik

Bermejo

2016

Therapeutic Advances in Endocrinology

View full text Add to dashboard Cite

show abstract

Treatment modality, diabetic control and blood homeostasis in type 2 diabetes mellitus patients in Basra

Kadhim¹,

Abdullah²,

Sabah³

2021

Current Issues in Pharmacy and Medical Sciences

View full text Add to dashboard Cite

This study is aimed at investigating the relationship between treatment modality, glycemic control and blood homeostasis as represented by prothrombin time (PT) and activated thromboplastin time (APTT) in T2DM patients. Sixty-four type 2 diabetic patients (40 males and 24 females) on metformin or insulin or both for not less than six months of ages between 20 and 75 years were selected during their visit to Diabetes Endocrine and Metabolism Centers in two General Hospitals in Basra. Socioeconomic characteristics and treatment plans were recorded. Glycated haemoglobin (HbA1c), lipid profiles and hematological parameters measured in blood samples were taken. Lower mean HbA1c (p = 0.0383) was found in patients on metformin alone, higher percentage of hemoglobin was found in patients on insulin treatment, and higher levels of LDL (P = 0.0018) and HDL (P = 0.0241) in patients on metformin and insulin. Treatment manner had no effect on mean PT or APTT, however, there was a significant inverse correlation of PT with LDL (P = 0.0042), and a direct correlation of APTT with HbA1c (p = 0.0209) and an inverse correlation of APTT with platelets count (P = 0.0324) in patients on insulin treatment. In addition, there was a significant direct correlation of APTT with triglycerides (TG) (P = 0.0069) in patients on metformin treatment. In conclusion, lower mean of HbA1c was found only in patients receiving metformin drug alone, higher Hb percentage were found in patients treated with insulin alone, higher LDL and higher HDL levels were found in patients treated with both metformin and insulin for at least six months. Treatment manner had no effect on mean PT or APTT and further studies are needed to bring about understanding of diabetic control and blood homeostasis.

show abstract

Early Insulin Initiation—A Review of the Literature and Case Studies

2012

IJFP

View full text Add to dashboard Cite

Effect of Insulin Analogs on the Decline of Hemoglobin in Diabetic Patients with Nephropathy

Abstract: Insulin analogs mitigate the decline of hemoglobin in diabetic patients with impaired renal function. This might be due to a stimulating effect of insulin analogs on erythropoiesis via IGF receptor or a sustained activation of the insulin receptor.

Cited by 3 publications

References 24 publications

Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function

Treatment with insulin analogs, especially Glargine and Lispro, associates with better renal function and higher hemoglobin levels in Type 1 diabetic patients with impaired kidney function

Treatment modality, diabetic control and blood homeostasis in type 2 diabetes mellitus patients in Basra

Early Insulin Initiation—A Review of the Literature and Case Studies

Contact Info

Product

Resources

About