open access

Vol 4, No 2 (2003): Practical Diabetology
Other materials agreed with the Editors
Published online: 2003-04-28
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Insulin detemir is associated with more predictable glycemic control and reduced risk of hypoglycemia than NPH insulin in patients with type 1 diabetes on a basal-bolus regimen with premeal insulin aspart

Philippe Vague, Jean-Louis Selam, Svein Skeie, Ivo De Leeuw, Jan W.F. Elte, Hanne Haahr, Allan Kristensen, Eberhard Draeger
Diabetologia Praktyczna 2003;4(2):169-177.

open access

Vol 4, No 2 (2003): Practical Diabetology
Original articles (translated)
Published online: 2003-04-28

Abstract

INTRODUCTION. Insulin detemir is a soluble basal insulin analog with a unique mechanism of protracted action designed to reduce the variability associated with conventional basal insulins. This trial compared the glycemic control, risk of hypoglycemia, and effect on body weight of insulin detemir and NPH insulin in patients with type 1 diabetes treated with rapid-acting insulin aspart at meals.
MATERIAL AND METHODS. This study was a 6-month multinational open parallel-group comparison conducted at 46 centers in five countries and included 448 patients with type 1 diabetes randomized 2:1 to insulin detemir or NPH insulin, respectively.
RESULTS. After 6 months, comparable HbA1c levels were found between the two treatment groups. Fasting plasma glucose tended to be lower in patients treated with insulin detemir, but this difference was not statistically significant (–0.76 mmol/l, P = 0.097). Within-subject variation in self-measured fasting blood glucose was lower with insulin detemir than with NPH insulin (SD 3.37 vs. 3.78 mmol/l, P < 0.001). Risk of hypoglycemia was 22% lower with insulin detemir than with NPH insulin (P < 0.05) and 34% lower for nocturnal (2300–0600) hypoglycemia (P < 0.005). Nightly plasma glucose profiles were smoother and more stable with insulin detemir (P < 0.05). Body weight was significantly lower with insulin detemir at the end of the trial (P < 0.001).
CONCLUSIONS. Treatment with insulin detemir resulted in more predictable glycemic control, with smoother plasma glucose profiles than NPH insulin and a significant reduction in the risk of hypoglycemia. The reduction in body weight with insulin detemir is a potential additional advantage. Regimens optimized for insulin detemir may be able to improve glycemic control beyond that possible with NPH insulin.

Abstract

INTRODUCTION. Insulin detemir is a soluble basal insulin analog with a unique mechanism of protracted action designed to reduce the variability associated with conventional basal insulins. This trial compared the glycemic control, risk of hypoglycemia, and effect on body weight of insulin detemir and NPH insulin in patients with type 1 diabetes treated with rapid-acting insulin aspart at meals.
MATERIAL AND METHODS. This study was a 6-month multinational open parallel-group comparison conducted at 46 centers in five countries and included 448 patients with type 1 diabetes randomized 2:1 to insulin detemir or NPH insulin, respectively.
RESULTS. After 6 months, comparable HbA1c levels were found between the two treatment groups. Fasting plasma glucose tended to be lower in patients treated with insulin detemir, but this difference was not statistically significant (–0.76 mmol/l, P = 0.097). Within-subject variation in self-measured fasting blood glucose was lower with insulin detemir than with NPH insulin (SD 3.37 vs. 3.78 mmol/l, P < 0.001). Risk of hypoglycemia was 22% lower with insulin detemir than with NPH insulin (P < 0.05) and 34% lower for nocturnal (2300–0600) hypoglycemia (P < 0.005). Nightly plasma glucose profiles were smoother and more stable with insulin detemir (P < 0.05). Body weight was significantly lower with insulin detemir at the end of the trial (P < 0.001).
CONCLUSIONS. Treatment with insulin detemir resulted in more predictable glycemic control, with smoother plasma glucose profiles than NPH insulin and a significant reduction in the risk of hypoglycemia. The reduction in body weight with insulin detemir is a potential additional advantage. Regimens optimized for insulin detemir may be able to improve glycemic control beyond that possible with NPH insulin.
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Keywords

basal-bolus insulin regimen; insulin detemir; type 1 diabetes mellitus

About this article
Title

Insulin detemir is associated with more predictable glycemic control and reduced risk of hypoglycemia than NPH insulin in patients with type 1 diabetes on a basal-bolus regimen with premeal insulin aspart

Journal

Clinical Diabetology

Issue

Vol 4, No 2 (2003): Practical Diabetology

Article type

Other materials agreed with the Editors

Pages

169-177

Published online

2003-04-28

Bibliographic record

Diabetologia Praktyczna 2003;4(2):169-177.

Keywords

basal-bolus insulin regimen
insulin detemir
type 1 diabetes mellitus

Authors

Philippe Vague
Jean-Louis Selam
Svein Skeie
Ivo De Leeuw
Jan W.F. Elte
Hanne Haahr
Allan Kristensen
Eberhard Draeger

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