[Optimal timing of insulin detemir injection in patients with type 1 diabetes and poor metabolic control].
| Autor: | Segovia Portolés R; Servicio de Endocrinología, Hospital Universitario La Fe de Valencia, Valencia, España. rakseg@hotmail.com, Ferrer-García JC, Merino-Torres JF, Penalba MT, Albalat Galera R, Piñón-Selles F |
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| Jazyk: | Spanish; Castilian |
| Zdroj: | Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion [Endocrinol Nutr] 2010 Apr; Vol. 57 (4), pp. 140-6. Date of Electronic Publication: 2010 Mar 26. |
| DOI: | 10.1016/j.endonu.2010.02.001 |
| Abstrakt: | Aim: To compare different administration times of insulin detemir (IDet) in patients with type 1 diabetes and poor metabolic control. Material and Methods: This 24-week open study included 39 people with type 1 diabetes mellitus (DM) randomized to one injection of IDet before lunch (mean 14.24 + or - 00.36 (+ or - SD) h) or at bedtime (23.19 + or - 0.42 h). Whenever target glycemia levels were not reached, the regimen was switched to insulin therapy with two injections (IDet-12h). Insulin aspart was used before main meals. Results: At week 24, only 12.2% of patients remained in the IDet bedtime group and 30.3% in the IDet before lunch group. The remaining 57.5% joined the IDet-12h group. There were no differences between the IDet before lunch and IDet bedtime groups. A subanalysis including the three groups demonstrated better metabolic control in the IDet before lunch group (glycosylated hemoglobin (HbA1c) 7.1 + or - 0.2 vs. 7.6 + or - 0.4 and 8.1 + or - 0.2% in IDet before-lunch, IDet bedtime and IDet-12h, respectively; p<0.05). An HbA1c value below 7% was achieved in 30.3% of the patients: 15.2% in the IDet before-lunch group, 3.3% in the IDet bedtime group and 12.2% in IDet-12h group. Quality of life did not differ among treatment groups. Conclusions: One injection of IDet administered before lunch could improve metabolic control. However, most patients required two injections of IDet. (Copyright 2009 SEEN. Published by Elsevier Espana. All rights reserved.) |
| Databáze: | MEDLINE |
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