engleski

Insulin detemir is associated with lower risk of hypoglycemia compared to NPH insulin in people with type 1 diabetes

Hypoglycemia remains the major barrier to achievinig optimal glycemic control in people with type 1 diabetes. We investigated if basal-bolus therapy with insulin dtemir (Idet), a new soluble basal insulin analog, was superior to NPH in reducing risk of hypoglycemia. In this multinational, open.lable trial, 70 men/60 women with type 1 diabetes received Idet and NPH mornong and bedtime in a randomosed cross-over design in combination with insulin aspart (Iasp) at meals during two 16-week treatment periods. Hypoglycemia was analysed during the last 10 weeks of each treatment period and clasified as minor (PG<3.1, ni assistance needed), major (assistance needed) or symtoms only (pg not measured or >3.1).Risk of ncturnal and pverall hypoglycemia was 50% and 18% lower with Idet. than with NPH. Incidence of majoir hypoglycemiaswas numerically lower with Idet: rr 0.61. HbA1c decresed by 0.3% with both treatments and was comparable at 7.55% after 16 weeks. Within-person variation in mean home-measured PG was lower wit Idet. Nocturnal PG excursions measured for 43 pesons in hospital were also lower. The general safety prifile was comparable. In conclusion, I det was assocoatoed with a significantly lower risk of hypoglycemia compared to NPH at simmilar HbA1c when used in a basal-bolus regimen. The lower risk of hypoglycemia was probably related to more stable and predictable PG levels observed with Idet and may allow people to achieve toighter glycemic control.

detemir insulin ; hypoglycemia ; basal-bolus treatment

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