Vol 8, No 7 (2007): Practical Diabetology
Research paper
Published online: 2007-08-01

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The influence of detemir - a long acting analogue of insulin - on the metabolic homeostasis of diabetic patients. Observational study

K. Wasilewska, I. Jakubowska
Diabetologia Praktyczna 2007;8(7):249-260.

Abstract

BACKGROUND. The aim of this work is to estimate the metabolic homeostasis in cases of type 1 and type 2 diabetes, treated with intensive insulinotherapy, with the use of detemir - a long acting analogue of insulin.
MATERIAL AND METHODS. The research included 17 patients with type 1 diabetes and 11 patients with type 2 diabetes. These patients were so far treated with intensive insulinotherapy, using NPH insulin and short acting analogues of insulin (86%). In order to intensify the treatment basic insulin was supplanted with detemir insulin. After 3-6 months of observation the influence of the change in therapy was evaluated. The evaluation included fasting plasma glucose concentration, post-prandial glucose concentration, HbA1c concentration, number of hypoglycemia incidences, body weight. The statistic assessment was performed with the use of the McNemara test (p*) and the T test for associated samples (p**).
RESULTS. In the group, 36% of case showed a statistically significant (p* < 0.013) decrease in FPG followed by a 25% (p < 0.039) improvement in FPG stability. Using detemir as the basic insulin together with short acting analogues (86%) in intensive insulinotherapy, caused a 32% (p* < 0.039) increase in the number of patients with normal post-prandial glucouse concentration. Resulting from better metabolic homeostasis in the whole research group, there was a statistically significant decrease of HbA1c by 1.7% (p** < 0.001). The use of detemir led to a 17% reduction in the number of hypoglycemia incidences, including night hypoglycemia. One third of patients in the whole group reduced body weight.
CONCLUSIONS. The use of detemir led to an improvment in metabolic homeostasis, manifesting in: decrese in FPG and regulation of post-prandial glycemia, lower HbA1c concentration, lower of hypoglycemia incidences and decrease in body weight.

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