A Comparison of Bedtime Insulin Glargine with Bedtime Neutral Protamine Hagedorn Insulin in Patients with Type 2 Diabetes: Subgroup Analysis of Patients Taking Once-Daily Insulin in a Multicenter, Randomized, Parallel Group Study

Fonseca, Vivian; Bell, David S.H.; Berger, Sheldon; Thomson, Stephen P.; Mecca, T E

doi:10.1097/00000441-200411000-00007

Cited by 55 publications

(42 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its use as part of a multiple daily injection (MDI) regimen demonstrated good glucose control with less hypoglycemia than NPH insulin in adults with type 1 or type 2 diabetes (12,13). However, only one major randomized clinical trial in pediatric patients has examined the relative efficacy of insulin glargine-based MDI versus MDI regimens utilizing intermediate-acting insulins, and this study did not examine glucose variability (14).…”

mentioning

confidence: 99%

Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes

White

Chase²,

Arslanian

et al. 2009

Diabetes Care

View full text Add to dashboard Cite

OBJECTIVE -To compare the glucose variability associated with insulin glargine and NPH/ Lente insulin used as the basal insulin component of a multiple daily injection (MDI) regimen in pediatric patients with type 1 diabetes. CONCLUSIONS -Insulin glargine is associated with greater reductions in glucose variability than NPH/Lente insulin in pediatric patients with type 1 diabetes. RESEARCH DESIGN AND METHODS

show abstract

mentioning

confidence: 99%

Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes

White

Chase²,

Arslanian

et al. 2009

Diabetes Care

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7][8][9][10][11][12][13] In contrast, a recent, similarly designed retrospective study of patients receiving NPH insulin with inadequate glycemic control who switched to insulin glargine showed a significant decrease in HbA 1c values at the end of one year of treatment with insulin glargine, when compared with values while receiving treatment with NPH insulin. 24 However, the authors noted that other antidiabetic medications and prandial insulin were adjusted throughout the study and this could have been the reason for the improvement in HbA 1c at the end of the study.…”

Section: Discussionmentioning

confidence: 89%

“…[4][5][6][7][8][9][10][11][12][13] As a basal insulin, glargine has the advantage of once-daily dosing, and evidence suggests it may be associated with a lower incidence of hypoglycemia when compared to NPH insulin. 4,5,[7][8][9][10][11][12][13] However, patients with medical vulnerabilities who would most benefit from these advantages, including those who have a history of substance abuse, mental illness, or poor comprehension, often are excluded from controlled clinical trials, either by study design or loss to follow-up. 5,8,10 Studies have shown that medication adherence is associated with glycemic control, with increased adherence leading to decreases in HbA 1c .…”

Section: L I N I C a L R E P O R T Smentioning

confidence: 99%

Effect of switching medically vulnerable patients with uncontrolled diabetes from isophane insulin human to insulin glargine

Erickson

Devine

O’Young

et al. 2006

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

Purpose. The purpose of this observational study was to determine if switching from isophane insulin human (NPH) to insulin glargine would improve glycemic control in a medically vulnerable population with uncontrolled diabetes. Methods. A retrospective cohort review of patients' medical records was performed that recorded events occurring between January 1, 2001, and December 31, 2003. The cohort consisted of patients with diabetes in an adult medicine clinic at a county hospital. Patients were included if they were receiving NPH insulin for a minimum of six months and subsequently switched to insulin glargine for a minimum of six months. Results. The study included 43 patients. There was no significant difference in mean glycosylated hemoglobin (HbA 1c ) between NPH insulin (9.6%) and insulin glargine (9.7%) regimens (p = 0.78, 95% confidence interval, -0.62%, 0.82%). Neither was there a significant difference in the frequency or severity of hypoglycemic episodes between the two treatments. Patients experienced significantly fewer diabetesassociated visits over six months while on insulin glargine. Refill frequency did not differ significantly when patients were receiving NPH insulin versus insulin glargine. When analyzing patient characteristics, those of Hispanic ethnicity experienced HbA 1c values significantly higher than white patients. Several characteristics were associated with refill frequency. Conclusion. The results of our study indicate that both NPH-and glargine-based basal insulin regimens result in similar levels of glycemic control in a medically vulnerable population with diabetes, without significant differences in the number or severity of hypoglycemic episodes or in refill frequency.

show abstract

“…These studies have ranged in duration from 4 weeks to 5 years. [11][12][13][14][15][16][17][18][19][20] Baseline characteristics of the individuals studied have ranged from 27 to 35 kg/m 2 for body mass index, 55 to 62 years for age, and 8.3% to 9.7% for A1c. In most studies insulin was given once daily at bedtime, although one S-34 HEDRINGTON ET AL.…”

Section: Pharmacodynamics and Pharmacokineticsmentioning

confidence: 99%

“…However, two studies have demonstrated a 1 kg greater weight gain with NPH versus glargine. 12,19 Treatment satisfaction has also been assessed by Eliaschewitz et al 15 Despite insulin glargine and NPH resulting in similar improvements of A1c and FBG, higher treatment satisfaction scores were obtained with insulin glargine compared with NPH. Linked to this finding, Eliaschewitz et al 15 also showed that patients who received insulin glargine were more likely to achieve A1c £ 7% without confirmed nocturnal …”

Section: Pharmacodynamics and Pharmacokineticsmentioning

confidence: 99%

Basal Insulin Treatment in Type 2 Diabetes

Hedrington

Pulliam

2011

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Insulin glargine is the first 24-h recombinant DNA insulin analog introduced to the market. Substitution of glycine for asparagine and addition of two arginine residues raise the isoelectric point of insulin glargine and result in microprecipitates, delaying absorption from subcutaneous tissue. This delayed absorption result in fairly flat 24-h insulin concentration profiles with no discernible peak. Large, multicenter, randomized, controlled trials in patients with type 2 diabetes show that although NPH insulin and insulin glargine are equally effective in lowering glycosylated hemoglobin (A1c) and fasting blood glucose, there is a clear advantage of insulin glargine over NPH insulin in reducing nocturnal and overall hypoglycemia. Lower risk of hypoglycemia with glargine was also consistently demonstrated by trials comparing insulin glargine and premixed analog insulins. These studies also showed greater reduction in A1c with twice-daily premixed insulins compared with glargine, when insulin glargine was administered without mealtime insulin coverage. Insulin glargine was also compared with another insulin analog, insulin detemir. Trials showed that both insulin analogs are equally effective in lowering A1c and have comparable risk of hypoglycemia. Trials comparing insulin glargine with glucagon-like peptide-1 agonists showed comparable significant reductions in A1c with both regimens. Insulin glargine is well tolerated, has low immunogenicity, reduced risks for acute myocardial infarction, and a lower risk of hypoglycemia compared with NPH insulin in individuals with type 2 diabetes.

show abstract

A Comparison of Bedtime Insulin Glargine with Bedtime Neutral Protamine Hagedorn Insulin in Patients with Type 2 Diabetes: Subgroup Analysis of Patients Taking Once-Daily Insulin in a Multicenter, Randomized, Parallel Group Study

Cited by 55 publications

References 15 publications

Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes

Comparison of Glycemic Variability Associated With Insulin Glargine and Intermediate-Acting Insulin When Used as the Basal Component of Multiple Daily Injections for Adolescents With Type 1 Diabetes

Effect of switching medically vulnerable patients with uncontrolled diabetes from isophane insulin human to insulin glargine

Basal Insulin Treatment in Type 2 Diabetes

Contact Info

Product

Resources

About