Less nocturnal hypoglycemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes. HOE 901/3002 Study Group.
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Use of insulin glargine instead of NPH in insulin combination regimens in type 2 diabetes is associated with less nocturnal hypoglycemia and lower post-dinner glucose levels, consistent with peakless and longer duration of action of insulinglargine compared with NPH.Abstract:
OBJECTIVE: Available basal insulin formulations do not provide a constant and reliable 24-h insulin supply. We compared the efficacy and safety of glargine (a long-acting insulin analog) and NPH insulins in insulin-naive type 2 diabetic patients treated with oral antidiabetic agents. RESEARCH DESIGN AND METHODS: There were 426 type 2 diabetic patients (age 59 +/- 9 years, BMI 28.9 +/- 4.3 kg/m2, mean +/- SD) with poor glycemic control on oral antidiabetic agents randomized to treatment for 1 year with bedtime insulin glargine or bedtime NPH insulin. Oral agents were continued unchanged. The fasting blood glucose (FBG) target was 6.7 mmol/l (120 mg/dl). RESULTS: Average glycemic control improved similarly with both insulins (HbA(1c), [reference rangeread more
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Journal ArticleDOI
The Treat-to-Target Trial: Randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients
TL;DR: Systematically titrating bedtime basal insulin added to oral therapy can safely achieve 7% HbA(1c) in a majority of overweight patients with type 2 diabetes, thus reducing a leading barrier to initiating insulin.
Journal ArticleDOI
Management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes.
David M. Nathan,John B. Buse,Mayer B. Davidson,Robert J. Heine,Rury R. Holman,Robert S. Sherwin,Bernard Zinman +6 more
TL;DR: The development of new classes of blood glucose–lowering medications to supplement the older therapies, such as lifestyle-directed interventions, insulin, sulfonylureas, and metformin, has increased the treatment options for type 2 diabetes.
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Hypoglycemia in Diabetes
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Exenatide versus Insulin Glargine in Patients with Suboptimally Controlled Type 2 Diabetes: A Randomized Trial
TL;DR: This multicenter, 26-week, randomized trial compared the addition of exenatide or insulin glargine to regimens of 551 patients with suboptimally controlled type 2 diabetes, and found both additions led to similar reductions in hemoglobin A1c levels.
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Liraglutide vs insulin glargine and placebo in combination with metformin and sulfonylurea therapy in type 2 diabetes mellitus (LEAD-5 met+SU): a randomised controlled trial
David Russell-Jones,Allan Vaag,Ole Schmitz,B. K. Sethi,N. lalic,S. Antic,Milan Zdravkovic,G. M. Ravn,Rafael Simó +8 more
TL;DR: Liraglutide added to metformin and sulfonylurea produced significant improvement in glycaemic control and bodyweight compared with placebo and insulin glargine.
References
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Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus. A randomized, controlled trial.
TL;DR: In this article, a randomized controlled trial was conducted to determine whether bedtime insulin regimens differ with respect to their effects on weight gain in patients with type 2 diabetes, and the results showed that combination therapy with oral hypoglycemic agents and bedtime-intermediate-acting insulin produces similar improvement in glycemic control but induces less weight gain.
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TL;DR: Combined insulin-sulfonylurea therapy leads to modest improvement in glycemic control compared with insulin therapy alone and obese patients with higher fasting C-peptides may be more likely to respond than others.
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