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Volume 22 |
January March 2006 |
Number 1 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ISSN 1681-715X |
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Volume 22 |
January March 2006 |
Number 1 |
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Comparison of Basal Insulin added to oral agents versus twice – Daily Premixed Insulin as Initial Insulin Therapy for Type 2 Diabetes
Abdul Rehman Al-Shaikh
To compare the efficacy and safety of adding once – daily basal Glargine insulin versus switching to twice – daily premixed insulin in Type-II diabetic patients not well controlled by combined oral antidiabetic agents.Abstract:
Objective:
Methods: In a 6 months parallel group clinical trail on 221 patients with Type-II diabetes and poorly controlled on oral antidiabetic agents (fasting blood glucose > 140 mg/ dl and glycosylated hemoglobin >8%) on oral antidiabetic treatment (metformin plus sulfonylurea) were randomized either to add Glargine insulin or to shift them to mixed insulin (30% regular insulin and 70% NPH) twice per day without oral antidiabetic treatment. Insulin dosage was titrated to target fasting blood glucose < 100 mg/dl and predinner blood glucose < 120 mg /dl.
Results: Mean hemoglobin A1C decrease from baseline was significantly pronounced (- 2.1 vs. -1.3 % p = <0.005), and more patients reached HbA1C <7% (57 vs. 31%) with Glargine insulin plus oral antidiabetic treatment than with mixed insulin. The number of patients who achieved the target of fasting blood glucose < 100 mg/dl were more in the group which received Glargine insulin than the other group that received mixed insulin (41.7 vs. 17.8 %).
Conclusions: Initiation of insulin therapy in patients with Type-II diabetes uncontrolled on combined metformin and sulfonylurea by adding Glargine insulin was more effective than starting with twice daily of mixed insulin (30% regular insulin and 70% NPH insulin).
Keywords: Type-II diabetes, insulin, Glargine insulin.
Pak J Med Sci January-March 2006 Vol. 22 No. 1 14-17
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