Tong Zhang1, Mingrun Lin2, Wangen Li3, Xiuyun Fan2, Tao Du2, Yunjuan Zhao2, Xiaodan Zhang2. 1. Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China. 2. Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. 3. Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. liwg660@126.com.
Abstract
INTRODUCTION: Previous studies comparing insulin detemir versus insulin glargine showed conflicting results, and included only outpatients. This study compared the two insulin analogs once daily in hospitalized patients with type 2 diabetes (T2D). METHODS: A total of 55 patients aged 18-80 years with hyperglycemia admitted to the endocrinology wards were screened between June 2014 and February 2015. Forty-two enrolled patients were randomly assigned to receive either insulin detemir followed by insulin glargine once daily (n = 21), or vice versa (n = 21). The two insulin analogs were titrated 0.1 U/kg once daily based on fasting blood glucose (FBG). After achieving FBG <7.8 mmol/L (the first period), subjects were switched from one analog to the other (the second period) with no change in the dose. The second period lasted for 3 days. When hypoglycemia occurred in the second period, the observation was discontinued. Six-point blood glucose including FBG, 2 h after breakfast, lunch, dinner, bedtime, and at 3:00 am was tested every day. The glucose profiles of the final days in the two periods were compared. RESULTS: At the end of the first period, days for achieving FBG target (4.0 ± 0.5 days vs. 3.3 ± 0.4 days, t = 1.079, P = 0.286) and total daily dose (30.1 ± 2.4 U vs. 30.1 ± 2.9 U, t = 0.002, P = 0.999) between insulin detemir and insulin glargine were similar. There was no significant difference in the 24-h glucose control between the two analogs. No hypoglycemia occurred with both analogs in the first period. However, in the second period, when insulin glargine was switched to insulin detemir, two, three and, one patients had hypoglycemia events on day 1, day 2 and day 3 of the second period, respectively. One patient had severe hypoglycemia on day 1. CONCLUSION: When both basal insulin analogs were given once daily in T2D, insulin detemir achieved similar efficacy to insulin glargine. On the other hand, there may be differences in action of the compared basal insulins. Further studies with larger patient samples are necessary to support evidence and reveal possible mechanisms.
RCT Entities:
INTRODUCTION: Previous studies comparing insulin detemir versus insulinglargine showed conflicting results, and included only outpatients. This study compared the two insulin analogs once daily in hospitalized patients with type 2 diabetes (T2D). METHODS: A total of 55 patients aged 18-80 years with hyperglycemia admitted to the endocrinology wards were screened between June 2014 and February 2015. Forty-two enrolled patients were randomly assigned to receive either insulindetemir followed by insulinglargine once daily (n = 21), or vice versa (n = 21). The two insulin analogs were titrated 0.1 U/kg once daily based on fasting blood glucose (FBG). After achieving FBG <7.8 mmol/L (the first period), subjects were switched from one analog to the other (the second period) with no change in the dose. The second period lasted for 3 days. When hypoglycemia occurred in the second period, the observation was discontinued. Six-point blood glucose including FBG, 2 h after breakfast, lunch, dinner, bedtime, and at 3:00 am was tested every day. The glucose profiles of the final days in the two periods were compared. RESULTS: At the end of the first period, days for achieving FBG target (4.0 ± 0.5 days vs. 3.3 ± 0.4 days, t = 1.079, P = 0.286) and total daily dose (30.1 ± 2.4 U vs. 30.1 ± 2.9 U, t = 0.002, P = 0.999) between insulindetemir and insulinglargine were similar. There was no significant difference in the 24-h glucose control between the two analogs. No hypoglycemia occurred with both analogs in the first period. However, in the second period, when insulinglargine was switched to insulindetemir, two, three and, one patients had hypoglycemia events on day 1, day 2 and day 3 of the second period, respectively. One patient had severe hypoglycemia on day 1. CONCLUSION: When both basal insulin analogs were given once daily in T2D, insulindetemir achieved similar efficacy to insulinglargine. On the other hand, there may be differences in action of the compared basal insulins. Further studies with larger patient samples are necessary to support evidence and reveal possible mechanisms.
Entities:
Keywords:
Endocrinology; Hyperglycemia; Insulin detemir; Insulin glargine; Type 2 diabetes
Authors: Thales B C Silva; Paulo H R F Almeida; Vania E Araújo; Francisco de Assis Acurcio; Augusto A Guerra Júnior; Brian Godman; Juliana Alvares Journal: Ther Adv Endocrinol Metab Date: 2018-06-22 Impact factor: 3.565
Authors: Xiaodan Zhang; Tong Zhang; Guangda Xiang; Wenbo Wang; Yanli Li; Tao Du; Yunjuan Zhao; Singla Sethiel Mosha; Wangen Li Journal: BMJ Open Diabetes Res Care Date: 2020-09