Unbound MEDLINE

Outcomes with insulin glargine in patients with type 2 diabetes previously on NPH insulin: evidence from clinical practice in Spain.

Abstract

AIM
We evaluated the effectiveness of insulin glargine (glargine)-based regimens in patients with type 2 diabetes mellitus (T2DM) in clinical practice in Spain.
METHODS
This was a retrospective, registry-based study of 1482 patients treated with neutral protamine Hagedorn (NPH) who were either switched to glargine or maintained on NPH at investigators' discretion. The primary outcomes were HbA(1c) change over a period of 4-9 months follow-up and incidence of hypoglycaemia.
RESULTS
Prior to switching treatment, mean ± standard deviation HbA(1c) was worse in the glargine vs. the NPH group (8.3 ± 1.2% vs. 7.9 ± 1.1% respectively; p < 0.0001). After 4-9 months of treatment, mean reductions in HbA(1c) were greater with glargine vs. NPH (-1.0 ± 1.0% vs. -0.2 ± 0.8% respectively; p < 0.0001) and the incidence of hypoglycaemia in the month prior to the study visit was lower (21.8% vs. 47.6% respectively; p < 0.0001). An expected reduction in dosing frequency, as well as in the basal insulin dose was reported for glargine vs. NPH, with 97.3% of glargine-treated patients on once-daily injections and 81.2% on NPH receiving twice-daily therapy. Improvements in treatment satisfaction were significantly higher with glargine (p < 0.0001).
CONCLUSIONS
In a Spanish clinical practice setting, patients with T2DM who switched to glargine from NPH experienced significantly greater reductions in mean HbA(1c) and a lower incidence of hypoglycaemia than patients maintained on NPH.

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  • Publisher Full Text

    • Authors

    Delgado E, LAUREL Spain study investigators

    Institution

    Hospital Universitario Central de Asturias, Oviedo, Spain.

    Source

    International journal of clinical practice 66:3 2012 Mar pg 281-8

    MeSH

    Administration, Oral
    Adult
    Aged
    Blood Glucose
    Diabetes Mellitus, Type 2
    Drug Substitution
    Female
    Hemoglobin A, Glycosylated
    Humans
    Hypoglycemia
    Hypoglycemic Agents
    Insulin, Isophane
    Insulin, Long-Acting
    Male
    Middle Aged
    Patient Satisfaction
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22340448