Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain in patients with type 2 diabetes who were insulin naive or treated with NPH or insulin glargine: clinical practice experience from a German subgroup of the PREDICTIVE study*

Meneghini, Luigi; Rosenberg, Kirsten; Koenen, Christoph; Meriläinen, Markus; Lüddeke, Hans-Joachim

doi:10.1111/j.1463-1326.2006.00674.x

Cited by 93 publications

(63 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

Section: Conventional Antidiabetic Therapeutics: Impact On Weightmentioning

confidence: 99%

“…Adjustment for change in HbA1c did not affect the finding [78]. In a subgroup analysis of the PREDICTIVE study evaluating individuals in a clinical practice setting who transferred from an OAD-only regimen to an OAD plus insulin detemir, NPH insulin or insulin glargine, all subgroups combined lost an average of 0.9 kg of body weight (p < 0.0001) [47].The clinical efficacy of rosiglitazone and pioglitazone as monotherapy or combination therapy with insulin, sulphonylureas or metformin is well established [79][80][81]. A class effect of TZDs, however, is treatment-associated weight gain and large, longitudinal studies such as ADOPT, DREAM and PROactive have shown that these agents can cause appreciable weight gain of up to 4-5 kg [41,42,44].…”

mentioning

confidence: 99%

“…Many conventional antidiabetic agents, including thiazolidinediones (TZDs), insulin, sulphonylureas and meglitinides, are associated with weight gain; an exception is metformin, which has been associated with weight neutrality or modest weight reduction [39][40][41][42][43][44]. As further discussed below, the newer basal formulation insulin detemir exhibits limited weight gain in comparison to neutral protamine Hagedorn (NPH) insulin [45,46] and detemir, NPH insulin and insulin glargine have demonstrated modest weight reductions in combination with oral antidiabetic drugs (OADs) in a realworld setting [47]. Nevertheless, a vicious circle may ensue with antidiabetic agents, with increases in weight resulting in a secondary increase in insulin resistance, which subsequently necessitates an increase in medication requirements to maintain glucose homeostasis.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Diabesity: therapeutic options

Colagiuri¹

2010

Diabetes Obesity Metabolism

102

View full text Add to dashboard Cite

A pathogenic relationship exists between type 2 diabetes and obesity. Over the last decade, the escalation in diabetes cases has paralleled the rapid increase in obesity rates, constituting a global health crisis. Environmental risk factors attributed to the global increase in obesity include the consumption of high-calorie, high-fat foods and inadequate physical activity. Obese individuals may also have a genetic predisposition for obesity. Both diabetes and obesity confer an elevated risk of developing a range of complications and comorbidities, including cardiovascular disease, hypertension and stroke, which can complicate disease management. This review examines the aetiology of the linkages between diabetes and obesity and the range of available therapies. Recent clinical evidence substantiating the efficacy and safety of incretin-based antidiabetic therapies is analysed, in addition to data on antiobesity therapeutic strategies, such as antiobesity agents, behaviour modification and bariatric surgery. Glucose control is often accompanied by weight-neutral or modest weight reduction effects with DPP-4 inhibitor treatment (sitagliptin, vildagliptin, saxagliptin) and weight loss with GLP-1 receptor agonist therapy (exenatide, liraglutide). Studies of antiobesity agents including orlistat, sibutramine and rimonabant have shown attrition rates of 30-40%, and the long-term effects of these agents remain unknown. Bariatric surgical procedures commonly performed are laparoscopic adjustable banding of the stomach and the Roux-en-Y gastric bypass, and have produced type 2 diabetes remission rates of up to 73%. Therapeutic strategies that integrate glycaemic control and weight loss will assume greater importance as the prevalence of diabetes and obesity increase. Keywords: DPP-4, exenatide, GLP-1 analogue, human, incretin, liraglutide, once-daily, type 2 diabetes mellitus Date submitted 2 June 2009; date of first decision 2 November 2009; date of final acceptance 4 November 2009 IntroductionThe term 'diabesity', coined by Sims and colleagues [1] in the 1970s, describes the strong link between type 2 diabetes and obesity [1,2]. As evidence of this pathogenic interrelationship continues to accumulate, so does the appearance of the term in the clinical literature. A large body of clinical evidence attests to the relationship between being overweight or obese and being at an elevated risk for development of type 2 diabetes [3][4][5][6][7]. The risk escalates with the degree of excess weight, increasing threefold with a body mass index (BMI) of 25.0-29.9 kg/m 2 and 20-fold with a BMI over 30 kg/m 2 [4]. In particular, abdominal fat accumulation exacerbates insulin resistance and confers a strong, independent risk of developing diabetes [8]. Global diabetes prevalence is estimated at 171 million and is projected to more than double, to 366 million, by 2030 [9]. Countries with the highest numbers of diabetes cases include India, China, USA, Indonesia and Japan [9][10][11]. The greatest relative increases in diabetes incide...

show abstract

Section: Conventional Antidiabetic Therapeutics: Impact On Weightmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Diabesity: therapeutic options

Colagiuri¹

2010

Diabetes Obesity Metabolism

102

View full text Add to dashboard Cite

show abstract

“…In randomized clinical trials (RCTs) in insulin-naïve people with T2D, basal insulin analogs have demonstrated better glycemic control with a lower risk of hypoglycemia compared with human neutral protamine Hagedorn (NPH) insulin [13][14][15][16][17][18] . Furthermore, the clinical effectiveness of basal insulin analogs in T2D has been demonstrated in real-life observational studies 5,[19][20][21][22][23] . Observational data are often collected from large heterogeneous populations that help enhance the generalizability of the clinical findings of RCTs.…”

Section: Introductionmentioning

confidence: 99%

An analysis of the cost-effectiveness of starting insulin detemir in insulin-naïve people with type 2 diabetes

Home

Baik

Gálvez

et al. 2014

Journal of Medical Economics

View full text Add to dashboard Cite

Aims:There is limited evidence with respect to the cost-effectiveness of starting insulin in people with diabetes outside the 'western' world. The aim of this study was to assess the cost-effectiveness of starting basal insulin treatment with insulin detemir in people with type 2 diabetes (T2D) inadequately controlled on oral glucose-lowering drugs (OGLDs) in Mexico, South Korea, India, Indonesia, and Algeria. Methods:The IMS CORE Diabetes Model was used to project clinical and cost outcomes over a 30-year time horizon. Clinical outcomes, baseline characteristics and health state utility data were taken from the A 1 chieve study. A 1-year analysis was also conducted based on treatment costs and quality-of-life data. Incremental costeffectiveness ratios (ICERs) were expressed as a fraction of GDP per capita, and WHO-CHOICE recommendations (ICER53.0) used to define cost-effectiveness. Results:Starting insulin detemir was associated with a projected increase in life expectancy (!1 year) and was considered cost-effective in all of the studied populations with ICERs of À0.02 (Mexico), 0.00 (South Korea), 0.48 (India), 0.12 (Indonesia), and 0.88 (Algeria) GDP/quality-adjusted life-year. Cost-effectiveness was maintained after conducting sensitivity analyses in the 30-year and 1-year analyses. A projected increase in treatment costs was partially offset by a reduction in complications. The difference in overall costs between insulin detemir and OGLDs alone was USD518, 1431, 3510, 15, and 5219, respectively. Conclusion:Changes in clinical outcomes associated with starting insulin detemir in insulin-naïve individuals with T2D resulted in health gains that made the intervention cost-effective in five countries with distinct healthcare resources.

show abstract

“…The insulin analogue insulin detemir causes fewer hypoglycaemic events and less weight gain, leading to improvements in quality adjusted life-years (QALYs) compared with NPH insulin 21,22 .…”

mentioning

confidence: 99%

Cost-effectiveness of insulin detemir compared with NPH insulin in people with type 2 diabetes in Denmark, Finland, Norway, and Sweden

Ridderstråle

Jensen

Gjesing

et al. 2013

Journal of Medical Economics

View full text Add to dashboard Cite

Objective: To assess the cost-effectiveness of insulin detemir compared with Neutral Protamine Hagedorn (NPH) insulin when initiating insulin treatment in people with type 2 diabetes mellitus (T2DM) in Denmark, Finland, Norway and Sweden.Methods: Efficacy and safety data were derived from a 20-week multicentre randomised controlled head-to-head clinical trial comparing insulin detemir and NPH insulin in insulin naïve people with T2DM, and short-term (one-year) cost effectiveness analyses were performed. As no significant differences in HbA 1c were observed between the two treatment arms, the model was based on significant differences in favour of insulin detemir in frequency of hypoglycaemia (Rate-Ratio = 0.52; CI: 0.44 -0.61) and weight gain (∆ 0.9 kg). Model outcomes were measured in Quality Adjusted Life Years (QALYs) using published utility estimates. Acquisition costs for insulin and direct healthcare costs associated with non-severe hypoglycaemic events were obtained from National Health Service public sources. One-way and probabilistic sensitivity analyses were performed. Conclusions:The lower risk of non-severe hypoglycaemia and less weight gain associated with using insulin detemir compared with NPH insulin when initiating insulin treatment in insulin naïve patients with type 2 diabetes provide economic benefits in the short-term. Based on cost/QALY threshold values, this represents good value for money in the Nordic countries. Using a short-term modelling approach may be conservative as reduced frequency of hypoglycaemia and less weight gain may also have positive long term health-related implications.3

show abstract

Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain in patients with type 2 diabetes who were insulin naive or treated with NPH or insulin glargine: clinical practice experience from a German subgroup of the PREDICTIVE study*

Abstract: These data confirm the short-term safety and efficacy of insulin detemir +/- OADs in a real-world scenario and support the findings of randomized controlled clinical trials with insulin detemir, including its limited effects on body weight.

Cited by 93 publications

References 28 publications

Diabesity: therapeutic options

Diabesity: therapeutic options

An analysis of the cost-effectiveness of starting insulin detemir in insulin-naïve people with type 2 diabetes

Cost-effectiveness of insulin detemir compared with NPH insulin in people with type 2 diabetes in Denmark, Finland, Norway, and Sweden

Contact Info

Product

Resources

About