| Autor: |
Ashwell, S. G., Amiel, S. A., Bilous, R. W., Dashora, U., Heller, S. R., Hepburn, D. A., Shutler, S. D., Stephens, J. W., Home, P. D. |
| Předmět: |
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| Zdroj: |
Diabetic Medicine; Mar2006, Vol. 23 Issue 3, p285-292, 8p, 1 Chart, 3 Graphs |
| Abstrakt: |
Aims To compare blood glucose control using insulin glargine + insulin lispro with that on NPH insulin + unmodified human insulin in adults with Type 1 diabetes managed with a multiple injection regimen. Methods In this 32-week, five-centre, two-way cross-over study, people with Type 1 diabetes ( n = 56, baseline HbA1c 8.0 ± 0.8%) were randomized to evening insulin glargine + mealtime insulin lispro or to NPH insulin (once- or twice-daily) + mealtime unmodified human insulin. Each 16-week period concluded with a 24-h inpatient plasma glucose profile. Results HbA1c was lower with glargine + lispro than with NPH + human insulin [7.5 vs. 8.0%, difference −0.5 (95% CI −0.7, −0.3) %, P < 0.001]. This was confirmed by an 8% lower 24-h plasma glucose area under the curve (AUC) (187 vs. 203 mmol l−1 h−1, P = 0.037), a 24% reduction in plasma glucose AUC > 7.0 mmol/l1 (47 vs. 62 mmol l−1 h−1, P = 0.017) and a 15% lower post-prandial plasma glucose AUC (75 vs. 88 mmol l−1 h−1, P = 0.002). There was no reduction in night-time plasma glucose AUC or increase in plasma glucose area < 3.5 mmol/l. Monthly rate of nocturnal hypoglycaemia was reduced by 44% with glargine + lispro (0.66 vs. 1.18 episodes/month, P < 0.001). Conclusions Compared with NPH insulin + unmodified human insulin, the combination of insulin glargine with a rapid-acting insulin analogue as multiple-injection therapy for Type 1 diabetes improves overall glycaemic control as assessed by HbA1c and 24-h plasma glucose monitoring to a clinically significant degree, together with a reduction in nocturnal hypoglycaemia. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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