Glimepiride combined with morning insulin glargine, bedtime neutral protamine Hagedorn insulin, or bedtime insulin glargine in patients with type 2 diabetes: a randomized, controlled trial

Article Abstract:

Background: Patients with type 2 diabetes are often treated with oral antidiabetic agents plus a basal insulin. Objective: To investigate the efficacy and safety of glimepiride combined with either morning or bedtime insulin glargine or bedtime neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes. Design: Open-label, randomized, controlled trial. Setting: 111 centers in 13 European countries. Patients: 695 patients with type 2 diabetes who were previously treated with oral antidiabetic agents. Intervention: Randomization to treatment with morning insulin glargine, bedtime NPH insulin, or bedtime insulin glargine for 24 weeks in addition to 3 mg of glimepiride. The insulin dose was titrated by using a predefined regimen to achieve fasting blood glucose levels of 5.56 mmol/L or lower (less than or equal to 100 mg/dL). Measurements: Hemoglobin A(sub 1c) values, blood glucose levels, insulin dose, and body weight. Results: Hemoglobin A(sub 1c) levels improved by ?1.24% (two-sided 90% CI, -1.10% to ?1.38%) with morning insulin glargine, by ?0.96 (CI, -0.81% to ?1.10%) with bedtime insulin glargine, and by ?0.84% (CI, -0.69% to ?0.98%) with bedtime NPH insulin. Hemoglobin A(sub 1c) improvement was more pronounced with morning insulin glargine than with NPH insulin (0.40% [CI, 0.23% to 0.58%]; P=0.001) or bedtime insulin glargine (0.28% [CI, 0.11% to 0.46%]; P=0.008). Baseline to end-point fasting blood glucose levels improved similarly in all three groups. Nocturnal hypoglycemia was less frequent with morning (39 of 236 patients [17%] and bedtime insulin glargine (52 of 227 patients [23%]) than with bedtime NPH insulin (89 of 232 patients [38%])(P<0.001). Conclusion: The risk for nocturnal hypoglycemia was lower with glimepiride in combination with morning and bedtime insulin glargine than with glimepiride in combination with bedtime NPH insulin in patients with type 2 diabetes. Morning insulin glargine provided better glycemic control than did bedtime insulin glargine or bedtime NPH insulin.

Evaluation, Author Abstract, Glimepiride

---

Pharmacologic Therapy for Type 2 Diabetes Mellitus

Article Abstract:

The mechanism of action, effectiveness, cost, and safety profile of each of the five classes of oral drugs for treating type 2 diabetes is described. The drugs include insulin, metformin, and the sulfonylureas. Studies have shown that controlling blood sugar levels can reduce the risk of developing the complications of diabetes. These complications include retinal disease, nerve disease and kidney disease. Type 2 diabetes is caused by defects in insulin secretion and resistance to insulin at the cellular level.

---

A comparison of three insulin regimens (morning glargine, bedtime glargine, or bedtime neutral protamine Hagedorn) in addition to a pill for treating type 2 diabetes

Article Abstract:

Injecting insulin glargine in the morning may be more effective in controlling blood sugar in people with type 2 diabetes than injecting it at night or using NPH insulin at night, according to a study of 695 patients. Insulin glargine is a long-acting form of insulin that can last for 24 hours and does not peak. For this reason, it should not cause low blood sugar during the night even when injected in the morning.

Care and treatment, Dosage and administration, Insulin

Similar abstracts:

• Abstracts: Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial
• Abstracts: Consulting patients on education strategy. Placebo inhaler devices and infection risks. An overview of education for patients with rheumatic diseases
• Abstracts: Cementing resin-bonded fixed partial dentures: a simplified technique. Fabrication of immediate transitional denture for patients with fixed partial dentures
• Abstracts: Hereditary proteinuria syndromes and mechanisms of proteinuria. Alport's syndrome, Goodpasture's syndrome, and type IV collagen
• Abstracts: Is noncentral obesity metabolically benign? Implications for prevention from a population survey. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.