Abstract
Aim
To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive
type 2 diabetes patients in terms of efficacy and safety.
Methods
An open-label study performed at a single center, comprised a randomized, crossover
24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated
with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24
week.
Results
A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8%
(±2.0) and 1.5% (±1.4) within the first 12 weeks (p < 0.01), whereas increased by 0.21% (±0.7) and 0.14% (±0.8) in the second 12 weeks (p > 0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first
12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily
dose. Within the first and second periods, the body weight of the patients was observed
an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period.
Conclusion
Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose
use of insulin did not provide a prominent glycemic control advantage on 1.5-fold
higher use of insulin.
Keywords
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References
- Abnormal patterns of insulin secretion in non-insulin dependent diabetes mellitus.N. Engl. J. Med. 1988; 318: 1231-1239
- Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33).Lancet. 1998; 352: 837-853
- Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes.Diabetes. 2004; 53: 1614-1620
- Basal insulin analogues in the management of diabetes mellitus: what progress have we made?.Diabetes Metab. Res. Rev. 2013; (in press)https://doi.org/10.1002/dmrr.2469
- Insulin analogs: impact on treatment success, satisfaction, quality of life, and adherence.Clin. Med. Res. 2008; 6: 54-67
- The mechanism of protraction of insulin detemir, a long-acting, acylated analog of human insulin.Pharm. Res. 2004; 21: 1498-1504
- A doubleblind, randomized, dose–response study investigating the pharmacodynamic and pharmacokinetic properties of the long-acting insulin analog detemir.Diabetes Care. 2005; 28: 1107-1112
- Levemir® (Insulin Detemir [rDNA Origin] Injection) [Prescribing Information].Novo Nordisk Inc., Princeton, NJ2009
- Albumin-bound basal insulin analogues (insulin detemir and NN344): comparable time–action profiles but less variability than insulin glargine in type 2 diabetes.Diabetes Obes. Metab. 2007; 9: 290-299
- Detemir as a once-daily basal insulin in type 2 diabetes.Clin. Pharmacol. 2011; 3: 27-37
- Comparison of once-versus twice-daily administration of insulin detemir: used with mealtime insulin aspart, in basal-bolus therapy for type 1 diabetes assessment of detemir administration in a progressive treat-to-target trial (ADAPT).Diabetes Care. 2009; 32: 32-37
- Refining basal insulin therapy: what have we learned in the age of analogs?.Diabetes Metab. Res. Rev. 2007; 23: 441-454
- A randomised, 52-week, treat-to-target trial comparing insulin detemir with insulin glargine when administered as add-on to glucose-lowering drugs in insulin-naive people with type 2 diabetes.Diabetologia. 2008; 51: 408-416
- Comparison of insulin detemir and insulin glargine using a basal-bolus regimen in a randomized, controlled clinical study in patients with type 2 diabetes.Diabetes Metab. Res. Rev. 2009; 25: 542-548
- PREDICTIVE – a global, prospective observational study to evaluate insulin detemir treatment in types 1 and 2 diabetes: baseline characteristics and predictors of hypoglycaemia from the European cohort.Diabetes Obes. Metab. 2007; 9: 428-434
- Transferring to insulin detemir from NPH insulin or insulin glargine in type 2 diabetes patients on basal-only therapy with oral antidiabetic drugs improves glycaemic control and reduces weight gain and risk of hypoglycaemia: 14-week follow-up data from PREDICTIVE™.Diabetes Obes. Metab. 2008; 10: 75-81
- Effect of insulin detemir dose frequency on clinical outcomes in patients with diabetes in PREDICTIVE.Adv. Ther. 2009; 26: 535-551
- 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.Diabetes Obes. Metab. 2007; 9: 418-427
- 3-Month results from Denmark within the globally prospective and observational study to evaluate insulin detemir treatment in type 1 and type 2 diabetes: the PREDICTIVE study.Rev. Diabet. Stud. 2007; 4: 89-97
- Insulin detemir improves glycaemic control without weight gain in insulin–naive patients with type 2 diabetes: subgroup analysis from the PREDICTIVE study.Int. J. Clin. Pract. 2008; 62: 659-665
- Pharmacokinetic and pharmacodynamic properties of long-acting insulin analogue NN304 in comparison to NPH insulin in humans.Exp. Clin. Endocrinol. Diabetes. 2000; 108: 100-105
- Metabolic control in noninsulin-dependent diabetes mellitus: factors associated with patient outcomes.Diabetes Care. 1987; 10: 697-701
- A 1-year multicenter randomized double-blind comparison of repaglinide and glyburide for the treatment of type 2 diabetes. Dutch and German Repaglinide Study Group.Diabetes Care. 1999; 22: 463-467
Article info
Publication history
Published online: February 11, 2014
Accepted:
January 18,
2014
Received in revised form:
January 17,
2014
Received:
November 11,
2013
Identification
Copyright
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.
