Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Pieber, TR; Draeger, E; Kristensen, A; Grill, V.
Comparison of three multiple injection regimens for Type 1 diabetes: morning plus dinner or bedtime administration of insulin detemir vs. morning plus bedtime NPH insulin.
DIABETIC MED. 2005; 22: 850-857.
Doi: 10.1111/j.1464-5491.2005.01545.x
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- Führende Autor*innen der Med Uni Graz
- Pieber Thomas
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- Abstract:
- AIMS: This trial investigated the efficacy and safety of two different administration-time regimens with insulin detemir (IDet) to that of a conventional basal insulin regimen with NPH insulin (NPH). METHODS: This multinational, 16-week, open, parallel group trial included 400 people with Type 1 diabetes mellitus (DM) randomized to IDet either morning and before dinner (IDetmorn+din) or morning and bedtime (IDetmorn+bed), or to NPH morning and bedtime (NPHmorn+bed), all in combination with mealtime insulin aspart (IAsp). RESULTS: HbA1c was comparable between the three groups after 16 weeks (P = 0.64), with reductions of 0.39-0.49% points. Lower fasting plasma glucose (FPG) was observed with IDetmorn+din and IDetmorn+bed compared with NPHmorn+bed (9.8 and 9.1 vs. 11.1 mmol/l, P = 0.006), whereas the IDet groups did not differ (P = 0.15). Within-person variation in self-measured FPG was significantly lower for both IDet regimens (sd IDetmorn+din 2.5, IDetmorn+bed 2.6 mmol/l) than for NPHmorn+bed (sd 3.1 mmol/l, P < 0.001), but was comparable between the IDet groups (P = 0.48). Ten-point plasma glucose profiles were lower between dinner and breakfast in the IDetmorn+din group (P = 0.043), compared with the two other groups. Risk of overall and nocturnal hypoglycaemia was similar for the three groups. Lower mean bodyweight was observed with IDet compared with NPH after 16 weeks (difference: (IDetmorn+din)-1.3 kg, P < 0.001, (IDetmorn+bed)-0.6 kg, P = 0.050). CONCLUSIONS: Both IDet regimens were well tolerated and provided lower and less variable glucose levels with no, or less, weight gain than NPH at comparable HbA1c. IDet can be administered either at dinner or bedtime, with similar glycaemic control according to the need of the individual person.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Blood Glucose - analysis
- Comparative Study - analysis
- Diabetes Mellitus, Type 1 - drug therapy
- Drug Administration Schedule - drug therapy
- Female - drug therapy
- Hemoglobin A, Glycosylated - analysis
- Humans - analysis
- Hypoglycemia - complications
- Hypoglycemic Agents - administration and dosage
- Insulin - administration and dosage
- Insulin, Isophane - administration and dosage
- Male - administration and dosage
- Treatment Outcome - administration and dosage
- Weight Loss - drug effects
- Find related publications in this database (Keywords)
- bodyweight
- hypoglycaemia
- insulin aspart
- insulin detemir
- within-person variability