Add-on treatment with intermediate-acting insulin versus sliding-scale insulin for patients with type 2 diabetes or insulin resistance during cyclic glucocorticoid-containing antineoplastic chemotherapy: a randomized crossover study.

Autor: Gerards MC; Department of internal medicine, MC Slotervaart, Amsterdam, The Netherlands. m.c.gerards@amc.uva.nl., de Maar JS; Department of internal medicine, Isala, Zwolle, The Netherlands., Steenbruggen TG; Department of medical oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Hoekstra JB; Department of internal medicine, Academic Medical Centre, Amsterdam, The Netherlands., Vriesendorp TM; Department of internal medicine, Isala, Zwolle, The Netherlands., Gerdes VE; Department of internal medicine, MC Slotervaart, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2016 Oct; Vol. 18 (10), pp. 1041-4. Date of Electronic Publication: 2016 Jul 22.
DOI: 10.1111/dom.12694
Abstrakt: The aim of this study was to compare the effectiveness and safety of intermediate-acting insulin (IMI) titrated on body weight and glucocorticoid dose with that of short-acting sliding-scale insulin (SSI) in patients on recurrent high-dose glucocorticoid-containing chemotherapy. We enrolled 26 patients with type 2 diabetes mellitus or random blood glucose level >12 mmol/l in a previous cycle of chemotherapy in a randomized crossover study. In two consecutive cycles of glucocorticoid-containing chemotherapy, participants were treated with either IMI or SSI, as add-on to routine diabetes medication. We compared time spent in target range (3.9-10 mmol/l), measured by continuous glucose monitoring (CGM), and the occurrence of hypoglycaemia. IMI resulted in a higher proportion of glucose values within target range than SSI (34.4 vs 20.9%; p < 0.001). There were no severe or symptomatic hypoglycaemic events. Two participants in each group had a subclinical hypoglycaemia detected only by CGM. Once-daily IMI resulted in better glycaemic control than SSI in patients with glucocorticoid-induced hyperglycaemia during chemotherapy. Safety was not compromised as the incidence of hypoglycaemia was low and not different between both regimens.
(© 2016 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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