Pdb74 Effects of an Intensified Therapy With Insulin Glargineand Insuline Glulisine on Patient Reported Outcomes in Diabetes Mellitus

Daikeler, R; Hoegy, B

doi:10.1016/s1098-3015(10)65021-8

Cited by 3 publications

(9 citation statements)

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“…56 In a second study of longer duration, 1,447 patients who were switched from various insulin regimens to basalbolus therapy with insulin glargine and insulin glulisine experienced a significant mean reduction in A1C of 1% over 6 months from a baseline of 8.0%. 54 These findings support the evidence gained in randomized controlled trials. Nevertheless, one must interpret such studies with care, because of the lack of a comparator group, and the potential for bias through patient selection, and limited data collection-hypoglycemia, for example, is often under-reported in such studies.…”

Section: Insulin Glargine-based MDI Therapy Versus Csiisupporting

confidence: 66%

“…There is ample evidence from everyday clinical practice to demonstrate the efficacy of insulin analogs. [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] Switching to insulin analog-based MDI regimens was associated with marked improvements in glycemic control. For example, in an observational study of 1,942 patients who were switched from NPH insulin to insulin glargine, mean A1C declined by 0.8% over 6 weeks of treatment, from 8.0% at baseline.…”

Section: Insulin Glargine-based MDI Therapy Versus Csiimentioning

confidence: 99%

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Clinical Experience with Insulin Glargine in Type 1 Diabetes

Garg

Moser

Dain

et al. 2010

Diabetes Technology & Therapeutics

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The Diabetes Control and Complications Trial (DCCT) demonstrated the importance of optimal glycemic control achieved through intensive insulin therapy in reducing the microvascular complications associated with type 1 diabetes. However, the DCCT, which was conducted prior to the availability of insulin analogs, also reported a significant increase in severe hypoglycemia with intensive versus conventional therapy. Insulin analogs were developed to aid patients in achieving better diabetes control by providing insulins with optimized pharmacokinetic and pharmacodynamic characteristics. Insulin glargine was the first long-acting insulin analog with a 24-h duration of action, offering once-daily injection, and has now been in clinical use for over 10 years. The authors performed a systematic search of EMBASE, MEDLINE, and Web of Science (Science Citation Index) to determine the efficacy of insulin glargine in type 1 diabetes in basal-bolus insulin regimens. Randomized controlled trials have demonstrated that glycemic control with insulin glargine is at least comparable to that with neutral protamine Hagedorn (NPH) insulin in adults and in children and adolescents, and with continuous subcutaneous insulin infusion in adults. However, these same trials show a significantly lower risk for hypoglycemia with insulin glargine compared with NPH insulin in adults.

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Section: Insulin Glargine-based MDI Therapy Versus Csiisupporting

confidence: 66%

Section: Insulin Glargine-based MDI Therapy Versus Csiimentioning

confidence: 99%

Clinical Experience with Insulin Glargine in Type 1 Diabetes

Garg

Moser

Dain

et al. 2010

Diabetes Technology & Therapeutics

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“…The absolute 95% CIs for the HbA 1c indicate that at baseline >95% of patients were above, but after 24 weeks of BBT >95% of patients were within the HbA 1c target range between 6.5% and 7.5%, a range that is widely accepted. 6 , 7 , 13 Daikeler et al 12 showed a mean decrease in HbA 1c by −1.0% for 1,447 type 1 diabetes mellitus (T1DM) patients and by −1.2% for 5,695 T2DM patients within 6 months for a similar BBT regimen also utilizing insulin glargine and insulin glulisine, representing results that are very close to the mean observed differences of −1.29% (pre-BOT) and −1.15% (pre-SIT), respectively, in this study. Results from other studies in T2DM patients based on daily clinical practice are also in good accordance with those reported herein.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, patient satisfaction was markedly improved after switching from inadequately controlled CT to a basal–bolus combination of insulin glargine and insulin glulisine. 11 , 12 …”

Section: Introductionmentioning

confidence: 99%

Effectiveness and tolerability of treatment intensification to basal–bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study

Pfohl¹,

Siegmund²,

Pscherer³

et al. 2015

VHRM

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BackgroundDue to the progressive nature of type 2 diabetes mellitus (T2DM), antidiabetic treatment needs to be continuously intensified to avoid long-term complications. In T2DM patients on either basal insulin-supported oral therapy (BOT) or supplementary insulin therapy (SIT) presenting with HbA1c values above individual targets for 3–6 months, therapy should be intensified. This study investigated effectiveness and tolerability of an intensification of BOT or SIT to a basal–bolus therapy (BBT) regimen in T2DM patients in daily clinical practice.MethodsThis noninterventional, 8-month, prospective, multicenter study evaluated parameters of glucose control, occurrence of adverse events (eg, hypoglycemia), and acceptance of devices in daily clinical practice routine after 12 and 24 weeks of intensifying insulin therapy to a BBT regimen starting from either preexisting BOT with insulin glargine (pre-BOT) or preexisting SIT with ≥3 daily injections of insulin glulisine (pre-SIT).ResultsA total of 1,530 patients were documented in 258 German medical practices. A total of 1,301 patients were included in the full analysis set (55% male, 45% female; age median 64 years; body mass index median 30.8 kg/m2; pre-BOT: n=1,072; pre-SIT: n=229), and 1,515 patients were evaluated for safety. After 12 weeks, HbA1c decreased versus baseline (pre-BOT 8.67%; pre-SIT 8.46%) to 7.73% and 7.66%, respectively (Δ mean −0.94% and −0.80%; P<0.0001). At week 24, HbA1c was further reduced to 7.38% and 7.30%, respectively (Δ mean −1.29% and −1.15%; P<0.0001), with a mean reduction of fasting blood glucose values in both treatment groups by more than 46 mg/dL. An HbA1c goal of ≤6.5% was reached by 17.9% (pre-BOT) and 18.6% (pre-SIT), and an HbA1c ≤7.0% by 46.1% (pre-BOT) and 43.0% (pre-SIT) of patients. During 24 weeks, severe as well as serious hypoglycemic events were rare (pre-BOT: n=5; pre-SIT: n=2; pretreated with both insulins: n=1).ConclusionIntensifying glargine-based BOT or glulisine-based SIT to a BBT regimen in poorly controlled T2DM patients in daily routine care led to marked improvements of glycemic control and was well tolerated.

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“…В другом исследовании большей продолжительности 1447 пациентов были переведены с различных схем инсулинотерапии на базально-болюсную терапию с использованием инсулинов гларгин и глулизин. При этом отмечалось значительное снижение уровня HbA 1c с 8% при включении в исследование на 1% за 6 месяцев лечения [23]. Эти работы подтверждают результаты рандомизированных клинических исследований.…”

Section: преимущества применения аналогов инсулина длительного действияunclassified

Modern approach to basal-bolus therapy with glargine and glulisine insulin analoguesin various age groups

et al. 2013

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DCCT (Diabetes Control and Complications Trial) study established that intensified insulin therapy in multiple daily injections (MDI) or continuous insulin infusion (CSII) regimens substantially reduce both development and progression of complications in patients with type 1 diabetes mellitus (T1DM) as compared to conventional insulin therapy. Insulin analogues possess better pharmacokinetic and pharmacodynamic characteristics than unmodified human insulin agents. These characteristics are beneficial for management of diabetes mellitus, allowing better glycemic outcomes with lower incidence of hypoglycemia.Current review discusses specifics of therapy with glargine (Lantus?) and glulisine (Apidra?) insulin analogues. Authors analyzed available to date results from corresponding clinical trials in children, adolescents and adults. Pharmacoeconomic aspects and matters of dosage of glargine and glulisine are further addressed.

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Pdb74 Effects of an Intensified Therapy With Insulin Glargineand Insuline Glulisine on Patient Reported Outcomes in Diabetes Mellitus

Cited by 3 publications

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Clinical Experience with Insulin Glargine in Type 1 Diabetes

Clinical Experience with Insulin Glargine in Type 1 Diabetes

Effectiveness and tolerability of treatment intensification to basal–bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study

Modern approach to basal-bolus therapy with glargine and glulisine insulin analoguesin various age groups

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Pdb74 Effects of an Intensified Therapy With Insulin Glargineand Insuline Glulisine on Patient Reported Outcomes in Diabetes Mellitus

Cited by 3 publications

References 0 publications

Clinical Experience with Insulin Glargine in Type 1 Diabetes

Clinical Experience with Insulin Glargine in Type 1 Diabetes

Effectiveness and tolerability of treatment intensification to basal&ndash;bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study

Modern approach to basal-bolus therapy with glargine and glulisine insulin analoguesin various age groups

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Effectiveness and tolerability of treatment intensification to basal–bolus therapy in patients with type 2 diabetes on previous basal insulin-supported oral therapy with insulin glargine or supplementary insulin therapy with insulin glulisine: the PARTNER observational study