Improving Metabolic Control in Sub-optimally Controlled Subjects with Type 1 Diabetes: Comparison of Two Treatment Algorithms Using Insulin Glargine.
From: Endocrinology and Diabetes Unit, Hospital Clínic Universitari, IDIBAPS, Barcelona University, Barcelona, Spain. rgomis@clinic.ub.es
Diabetes research and clinical practice
- Publish Date: Jul 2007
- ISSN: 0168-8227
- Volume: 77
- Issue: 1
- Pages: 84-91
- Medium: Print
- Language: English
- Citation (JAMA): Gomis Ramon, Storms Fred, Conget Ignacio, et al. Improving Metabolic Control in Sub-optimally Controlled Subjects with Type 1 Diabetes: Comparison of Two Treatment Algorithms Using Insulin Glargine.. Diabetes Res. Clin. Pract. Jul 2007;77:84-91
Abstract
This study assessed the incidence of severe hypoglycaemia with two insulin glargine titration algorithms: Algorithm 1 (increments of at least 10%, but not exceeding 4U) versus Algorithm 2 (1-6U increments). In this multicenter (n=409), multinational (n=54), open-label, 24-week randomized trial in 2442 subjects with sub-optimally controlled Type 1 diabetes (T1DM), mean prior insulin therapy duration was 14.6+/-10.3 years. The incidence of severe hypoglycaemia was similar with Algorithms 1 and 2 (16.6events/100 patient-years versus 14.4events/100 patient-years). There were similar rates of both symptomatic and nocturnal hypoglycaemia. HbA(1c) and fasting blood glucose (FBG) decreased significantly (baseline to endpoint; p<0.001), and comparably with Algorithms 1 and 2 (HbA(1c): -0.64% versus -0.72%; FBG: -57mg/dL versus -59mg/dL). Mean basal insulin dose increased with both algorithms (+5.7U versus +5.9U). In a diverse population with longstanding T1DM, transfer from any insulin regimen, including basal-bolus or premixed insulin to an insulin glargine-based regimen resulted in significant improvements in glycaemic control, with low rates of severe hypoglycaemia, irrespective of the titration algorithm used.
Mesh Headings (Keywords): Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Hemoglobin A, Glycosylated, Humans, Hypoglycemia, Hypoglycemic Agents, Insulin, Male, Middle Aged, Treatment Outcome
Check for Full Text / PubMed Unique Identifier (PMID): 17097185
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