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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Insulin detemir lowers the risk of hypoglycaemia and provides more consistent plasma glucose levels compared with NPH insulin in Type 1 diabetes
Diabetic Medicine, Volume 23, No. 7, Year 2006
Notification
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Description
Aims: Hypoglycaemia remains a major barrier preventing optimal glycaemic control in Type 1 diabetes due to the limitations of conventional insulin preparations. We investigated whether basal-bolus therapy with insulin detemir (detemir), a new soluble basal insulin analogue, was more effective in reducing the risk of hypoglycaemia compared with NPH insulin (NPH). Methods: In this multinational, open-label, cross-over trial, 130 individuals with Type 1 diabetes received detemir and NPH twice daily in a randomized order in combination with premeal insulin aspart (IAsp) during two 16-week treatment periods. Risk of hypoglycaemia was based on self-measured plasma glucose (SMPG) and self-reported episodes during the last 10 weeks of each period. Results: Risk of nocturnal and overall hypoglycaemia was, respectively, 50% and 18% lower with detemir than with NPH (P < 0.001). A total of 19 severe hypoglycaemic episodes occurred during treatment with detemir compared with 33 with NPH (NS). HbA1c decreased by 0.3% point with both treatments and was comparable at 7.6% (± sem 0.06%, 95% confidence interval -0.106, 0.108) after 16 weeks with similar doses of basal insulin. Within-person variation in mean plasma glucose was lower with detemir than with NPH (sd 3.00 vs. 3.33, P < 0.001), as was prebreakfast SMPG (P < 0.0001). Conclusions: Detemir was associated with a significantly lower risk of hypoglycaemia compared with NPH at similar HbA1c when used in combination with mealtime IAsp. The more consistent plasma glucose levels observed with detemir may allow people to aim for tighter glycaemic control without an increased risk of hypoglycaemia. © 2006 The Authors.
Authors & Co-Authors
Kølendorf, K.
Denmark, Koge
Diabetes Centre
Ross, G. P.
Australia, Sydney
Royal Prince Alfred Hospital
Pavlic-Renar, I.
Croatia, Zagreb
Clinical Hospital Merkur
Perriello, Gabrielle
Italy, Perugia
Università Degli Studi Di Perugia
Philotheou, Areti
South Africa, Cape Town
University of Cape Town
Jendle, Johan H.
Sweden
Trelleborg Hospital
Gall, M. A.
Denmark, Bagsvard
Novo Nordisk A/s
Heller, Simon R.
United Kingdom, Sheffield
Northern General Hospital
Statistics
Citations: 113
Authors: 8
Affiliations: 8
Identifiers
Doi:
10.1111/j.1464-5491.2006.01862.x
ISSN:
07423071
e-ISSN:
14645491
Research Areas
Noncommunicable Diseases