Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes. U.S. Study Group of Insulin Glargine in Type 1 Diabetes.

• R E Ratner

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

• I B Hirsch

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

• J L Neifing

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

• S K Garg

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

• T E Mecca

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

• C A Wilson

  MedStar Clinical Research Center, Washington, DC, USA. [e-mail]

抄録

OBJECTIVE: Insulin glargine (21A-Gly-30Ba-L-Arg-30Bb-L-Arg-human insulin) is a biosynthetic insulin analog with a prolonged duration of action compared with NPH human insulin. This study compared insulin glargine with NPH human insulin in subjects with type 1 diabetes who had been previously treated with multiple daily injections of NPH insulin and regular insulin. RESEARCH DESIGN AND METHODS: This study was a multicenter randomized parallel-group study in which subjects were randomized to receive premeal regular insulin and either insulin glargine (at bedtime) or NPH insulin (at bedtime for patients on once-daily therapy and at bedtime and in the morning for patients on twice-daily therapy) for up to 28 weeks. Dose titration of both basal insulins was based on capillary fasting whole blood glucose (FBG) levels; the goal was a premeal blood glucose concentration of 4.4-6.7 mmol/l. RESULTS: A total of 534 well-controlled type 1 diabetic subjects (mean GHb 7.7%, mean fasting plasma glucose [FPG] 11.8 mmo/l) were treated. A small decrease in GHb levels was noted with both insulin glargine (-0.16%) and NPH insulin (-0.21%; P > 0.05). Significant reductions in median FPG levels from baseline (-1.67 vs. -0.33 mmol/l with NPH insulin, P = 0.0145) and a trend for a reduction in capillary FBG levels were achieved with insulin glargine. After the 1-month titration phase, significantly fewer subjects receiving insulin glargine experienced symptomatic hypoglycemia (39.9 vs. 49.2%, P = 0.0219) or nocturnal hypoglycemia (18.2 vs. 27.1%, P = 0.0116) with a blood glucose level <2.0 mmol/l compared with subjects receiving NPH insulin. CONCLUSIONS: Lower FPG levels with fewer episodes of hypoglycemia were achieved with insulin glargine compared with once- or twice-daily NPH insulin as part of a basal-bolus regimen in patients with type 1 diabetes.

収録刊行物

• Diabetes Care

  Diabetes Care 23 (5), 639-643, 2000-05-01

  American Diabetes Association

キーワード

• Advanced and Specialized Nursing
• Endocrinology, Diabetes and Metabolism
• Internal Medicine

詳細情報

• CRID: 1361418519762324864
• NII論文ID: 30026278489
• DOI: 10.2337/diacare.23.5.639
• ISSN: 19355548
• ISSN: 01495992
• ISSN: http://id.crossref.org/issn/01495992
• Web Site: https://diabetesjournals.org/care/article-pdf/23/5/639/450469/10834423.pdf
• データソース種別:
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  • CiNii Articles