Comparison of Insulin Detemir and Insulin Glargine on Glycemic Variability in Patients with Type 1 and Type 2 Diabetes

Tone, Atsuhito; Iseda, Izumi; Higuchi, Chigusa; Tsukamoto, Keiko; Katayama, Akihiro; Matsushita, Yukio; Hida, Kazuyuki; Wada, Jun; Shikata, Kenichi

doi:10.1055/s-0029-1243230

Cited by 16 publications

(12 citation statements)

References 12 publications

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“…As titration in this study was at the treating physicians’ discretion, the difference in the incidence of hypoglycaemia in favour of the insulin detemir group may be partly because of the varying up-titration between the two groups and the slightly higher HbA 1c values at final visit (7.48% vs. 7.38%) in patients treated with insulin detemir. However, reduced intra-patient glucose variability seen in patients treated with insulin detemir may also play a role [29-31]. Unlike some of the previous randomised controlled trials, where final insulin dose was found to be greater for insulin detemir compared with insulin glargine at the final visit [21-23], our data indicate similar end-of-study dose values between the two insulin analogues.…”

Section: Discussionsupporting

confidence: 47%

Lower risk of hypoglycaemia and greater odds for weight loss with initiation of insulin detemir compared with insulin glargine in Turkish patients with type 2 diabetes mellitus: local results of a multinational observational study

Damcı

Emral

Svendsen³

et al. 2014

BMC Endocr Disord

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BackgroundThe purpose of this analysis is to evaluate the safety and effectiveness of insulin initiation with once-daily insulin detemir (IDet) or insulin glargine (IGlar) in real-life clinical practice in Turkish patients with type 2 diabetes mellitus (T2DM).MethodsThis was a 24-week multinational observational study of insulin initiation in patients with T2DM.ResultsThe Turkish cohort (n = 2886) included 2395 patients treated with IDet and 491 with IGlar. The change in glycosylated haemoglobin (HbA1c) from the pre-insulin levels was -2.21% [95% confidence interval (CI) -2.32, -2.09] in the IDet group and -1.88% [95% CI -2.17, -1.59] in the IGlar group at the final visit. The incidence rate of minor hypoglycaemia increased in both groups from the pre-insulin to the final visit (+0.66 and +2.23 events per patient year in the IDet and IGlar groups, respectively). Weight change in the IDet group was -0.23 kg [95% CI -0.49, 0.02 kg], and +1.55 kg [95% CI 1.11, 2.00 kg] in the IGlar group. Regression analysis with adjustment for previously identified confounders (age, gender, duration of diabetes, body mass index, previous history of hypoglycaemia, microvascular disease, number and change in oral anti-diabetic drug therapy, HbA1c at baseline and insulin dose) identified an independent effect of insulin type (IDet versus IGlar) with a risk of at least one episode of hypoglycaemia (odds ratio (OR): 0.33 [95% CI 0.21, 0.52], p <0.0001), and weight loss ≥1 kg (OR: 1.75 [95% CI 1.18, 2.59], p = 0.005), but not on HbA1c (+0.05% [95% CI -0.15, 0.25%], p = 0.6).ConclusionsInitiation of basal insulin analogues, IDet and IGlar, were associated with clinically significant glycaemic improvements. A lower risk of minor hypoglycaemia and greater odds of weight loss ≥1 kg was observed with IDet compared with IGlar.Trial registrationNCT00825643 and NCT00740519

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Section: Discussionsupporting

confidence: 47%

Lower risk of hypoglycaemia and greater odds for weight loss with initiation of insulin detemir compared with insulin glargine in Turkish patients with type 2 diabetes mellitus: local results of a multinational observational study

Damcı

Emral

Svendsen³

et al. 2014

BMC Endocr Disord

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“…1). Lower variability of insulin detemir has also been demonstrated in several clinical studies of patients with DM [44,45].…”

Section: Glycemic Variability Hypoglycemic Risk and Pregnancy Outcomesmentioning

confidence: 73%

Detemir potential applications in the treatment of diabetes during pregnancy: proven benefits and perspectives

et al. 2016

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“…In a cross-over study, Tone et al had 15 Type 1 diabetic and 14 Type 2 diabetic patients on intensive insulin treatment who were switched from insulin detemir to insulin glargine or from insulin glargine to insulin detemir as the basal insulin and evaluated changes in glycemic variability with standard deviation and coefficient of variance of capillary glucose values. They found a beneficial effect of switching insulin glargine to insulin detemir in Type 1 diabetic patients who had high glycemic variability (20). However, Renard et al reported that insulin glargine had not weaker effect than did insulin determir according to the coefficient of variation and fasting blood glucose levels in their multicenter, randomized study with a 16-week crossover period on 78 Type 1 diabetic patients (21).…”

Section: Discussionmentioning

confidence: 98%

The Effect of Basal Analog Insulin on the Glycemic Variability in Type 2 Diabetics

Cander¹,

Gül²,

Dizdar³

et al. 2014

tjem

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Purpose:The aim of this study was to investigate the effect of insulin detemir and glargine on glycemic variability as determined by capillary blood glucose measurements in Type 2 diabetics treated with oral antidiabetic drugs. Material and Method: A total of 64 insulin-naive type 2 diabetics with a HbA1c level of 7.5%-10% were included in the study. The patients were randomized into 3 groups according to the basal insulin analog started; Group 1 (n=22) was started on once-daily detemir, Group 2 (n=22) twicedaily detemir, and Group 3 (n=20) insulin glargine. Basal insulin doses were titrated according to the morning/evening fasting capillary blood glucose levels. Standard deviations of the 8-point intraday fasting and postprandial blood glucose values were compared. Results: The fasting blood glucose intraday standard deviation values showed an improvement of 22.4% in Group 1, 21.4% in Group 2, and 26.4% in Group 3, while the intraday standard deviation for the postprandial values showed an improvement of 14.4%, 15.2%, and 38.7%, respectively (p>0.05). The standard deviation values did not show statistical significance when the groups were compared with each other. Baseline HbA1c values and insulin doses negatively correlated with the glycemic variability. Dicussion: Basal insulin added to treatment in Type 2 diabetics provided an improvement of 14.4% to 38.7% in glycemic variability. There was no significant difference between insulin glargine and detemir regarding this effect. Turk Jem 2014; 2: 33-38 Key words: Type 2 Diabetes, glycemic variability, basal insulin therapy Amaç: Bu çalışmanın amacı, oral antidiyabetik ilaçlar ile tedavi edilen Tip 2 diyabet hastalarında insülin detemir ve glarjinin, kapiller kan glukoz ölçümleri ile tespit edilen glisemik dalgalanmalar üzerine etkilerinin incelenmesidir. Gereç ve Yöntem: Daha önce hiç insulin kullanmamış ve HbA1c düzeyi %7,5-%10 arasında olan toplam 64 Tip 2 diyabetik hasta çalışmaya dahil edilmiştir. Hastalar başlanan bazal insulin analoguna göre 3 gruba randomize edildi; Grup 1'deki (n=22) hastalara günde tek doz insülin detemir, Grup 2'deki (n=22) hastalara günde iki doz detemir ve Grup 3'deki (n=20) hastalara insulin glarjin başlandı. Bazal insulin dozları sabah/ akşam açlık kapiller glukoz ölçüm düzeylerine göre titre edildi. Gün içi 8 nokta açlık ve öğün sonrası kan glukoz ölçümlerinin standart deviasyon değerleri karşılaştırıldı. Bulgular: Gün içi açlık kan glukoz ölçümlerinin gün içi standart sapma değerlerinde Grup 1'de %22,4, Grup 2'de %21,4 ve Grup 3'te %26,4 düzelme gözlenirken, öğün sonrası değerlerin standart sapma değerlerinde ise sırası ile %14,4, %15,2 ve %38,7 (p>0,05) düzelme tesbit edildi. Standart sapma değerleri her üç grup birebir karşılaştırıldığında istatistiksel olarak anlamlı fark tesbit edilmedi. Başlangıç HbA1c değerleri ve insulin dozları ile glisemik değişkenlik arasında negatif korelasyon tesbit edildi. Tartışma: Tip 2 diayebtiklerde tedaviye bazal insulin eklenmesi, glisemik dalgalanmalarda %14,4'ten %38,7'ye kadar iyileşme sağla...

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Comparison of Insulin Detemir and Insulin Glargine on Glycemic Variability in Patients with Type 1 and Type 2 Diabetes

Abstract: The present study demonstrated lower within-subject variability of insulin detemir compared to insulin glargine, suggesting that the basal insulin replacement with insulin detemir may provide a useful therapeutic strategy for uncontrolled type 1 diabetes with high glucose variability.

Cited by 16 publications

References 12 publications

Lower risk of hypoglycaemia and greater odds for weight loss with initiation of insulin detemir compared with insulin glargine in Turkish patients with type 2 diabetes mellitus: local results of a multinational observational study

Lower risk of hypoglycaemia and greater odds for weight loss with initiation of insulin detemir compared with insulin glargine in Turkish patients with type 2 diabetes mellitus: local results of a multinational observational study

Detemir potential applications in the treatment of diabetes during pregnancy: proven benefits and perspectives

The Effect of Basal Analog Insulin on the Glycemic Variability in Type 2 Diabetics

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