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Insulin detemir lowers the risk of hypoglycaemia and provides more consistent plasma glucose levels compared with NPH insulin in Type 1 diabetes
Diabetes Centre, Roskilde Amtssygehus, Køge, Denmark.
The Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia.
Outpatient Diabetes Department, Vuk Vrhovac Institute, Zagreb, Croatia.
Department of Internal Medicine, University of Perugia, Perugia, Italy.
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2006 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 23, no 7, p. 729-735Article in journal (Refereed) Published
Abstract [en]

AIMS: Hypoglycaemia remains a major barrier preventing optimal glycaemic control in Type 1 diabetes due to the limitations of conventional insulin preparations. We investigated whether basal-bolus therapy with insulin detemir (detemir), a new soluble basal insulin analogue, was more effective in reducing the risk of hypoglycaemia compared with NPH insulin (NPH).

METHODS: In this multinational, open-label, cross-over trial, 130 individuals with Type 1 diabetes received detemir and NPH twice daily in a randomized order in combination with premeal insulin aspart (IAsp) during two 16-week treatment periods. Risk of hypoglycaemia was based on self-measured plasma glucose (SMPG) and self-reported episodes during the last 10 weeks of each period.

RESULTS: Risk of nocturnal and overall hypoglycaemia was, respectively, 50% and 18% lower with detemir than with NPH (P < 0.001). A total of 19 severe hypoglycaemic episodes occurred during treatment with detemir compared with 33 with NPH (NS). HbA(1c) decreased by 0.3% point with both treatments and was comparable at 7.6% (+/- sem 0.06%, 95% confidence interval -0.106, 0.108) after 16 weeks with similar doses of basal insulin. Within-person variation in mean plasma glucose was lower with detemir than with NPH (sd 3.00 vs. 3.33, P < 0.001), as was prebreakfast SMPG (P < 0.0001).

CONCLUSIONS: Detemir was associated with a significantly lower risk of hypoglycaemia compared with NPH at similar HbA1c when used in combination with mealtime IAsp. The more consistent plasma glucose levels observed with detemir may allow people to aim for tighter glycaemic control without an increased risk of hypoglycaemia.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2006. Vol. 23, no 7, p. 729-735
Keywords [en]
hypoglycaemia, insulin aspart, insulin detemir, Type 1 diabetes, within-person variation
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-74508DOI: 10.1111/j.1464-5491.2006.01862.xISI: 000238618400004PubMedID: 16842476Scopus ID: 2-s2.0-33748555885OAI: oai:DiVA.org:oru-74508DiVA, id: diva2:1319145
Available from: 2019-05-29 Created: 2019-05-29 Last updated: 2019-06-10Bibliographically approved

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Jendle, Johan

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