Effect of two starting insulin regimens in patients with type II diabetes not controlled on a combination of oral antihyperglycemic medications

Z. Milicevic, N. Hancu, N. Car, T. Ivanyi, M. Schwarzenhofer, G. Jermendy

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

In an open-label, 24-week, parallel-group study, 135 patients inadequately controlled with oral antihyperglycemic medications (OAMs) were treated with maximally tolerated doses of metformin and glibenclamide for at least 8 weeks and then randomized to bedtime neutral protamine Hagedorn (NPH) insulin plus maximally tolerated dose of glibenclamide BID (glib / NPH group) or insulin lispro mix 50 (50 % lispro, 50 % insulin lispro protamine suspension [ILPS]) prebreakfast and lispro mix 25 (25 % lispro, 75 % ILPS) pre-dinner (LM50 / LM25 group) (both OAMs discontinued). The LM50 / LM25 group had signifi cantly lower 2-hour postprandial BG (both meals combined) compared with glib / NPH after 12 (11.70 ± 3.40 mmol / L vs. 13.15 ± 2.44 mmol / L, p = 0.010) and 24 weeks (11.13 ± 3.31 mmol / L vs. 14.46 ± 2.93 mmol / L, p = 0.0001). Both regimens significantly decreased HbA1c. The reduction was greater with LM50 / LM25 ( - 1.31 ± 2 % vs. - 0.5 ± 1.6 %; p = 0.01). At endpoint, the overall hypoglycemia rate increased with LM50 / LM25 and decreased with glib / NPH compared with baseline (0.22 ± 0.9 vs. - 0.08 ± 0.72 episodes / patient / 30 days; p = 0.037). Treatment with LM50 / LM25 compared with glib / NPH in patients with inadequate control on combined OAMs yielded better postprandial and overall glycemic control with a higher rate of hypoglycemia.

Original languageEnglish
Pages (from-to)223-229
Number of pages7
JournalExperimental and Clinical Endocrinology and Diabetes
Volume117
Issue number5
DOIs
Publication statusPublished - May 2009

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Insulin Lispro
Protamines
Hypoglycemic Agents
Type 2 Diabetes Mellitus
Insulin
Maximum Tolerated Dose
Glyburide
Hypoglycemia
Meals
Suspensions
Isophane Insulin
Metformin

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Medicine(all)

Cite this

Effect of two starting insulin regimens in patients with type II diabetes not controlled on a combination of oral antihyperglycemic medications. / Milicevic, Z.; Hancu, N.; Car, N.; Ivanyi, T.; Schwarzenhofer, M.; Jermendy, G.

In: Experimental and Clinical Endocrinology and Diabetes, Vol. 117, No. 5, 05.2009, p. 223-229.

Research output: Contribution to journalArticle

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