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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
biochemistry, genetics and molecular biology
Comparison of inpatient insulin regimens with detemir plus aspart Versus neutral protamine hagedorn plus regular in medical patients with type 2 diabetes
Journal of Clinical Endocrinology and Metabolism, Volume 94, No. 2, Year 2009
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Description
Background: Studies comparing the use of basal bolus with insulin analogs vs. split-mixed regimens with human insulins in hospitalized patients with type 2 diabetes are lacking. Research Design and Methods: In a controlled multicenter trial, we randomized 130 nonsurgical patients with blood glucose (BG) between 140 and 400 mg/dl to receive detemir once daily and aspart before meals (n = 67) or neutral protamine Hagedorn (NPH) and regular insulin twice daily (n = 63). Insulin dose was started at 0.4 U/kg · d for BG between 140 and 200 mg/dl or 0.5 U/kg · d for BG 201-400 mg/dl. Major study outcomes included differences in mean daily BG levels and frequency of hypoglycemic events between treatment groups. Results: Glycemic control improved similarly in both groups from a mean daily BG of 228 ± 54 and 223 ± 58 mg/dl (P = 0.61) to a mean daily BG level after the first day of 160 ± 38 and 158 ± 51 mg/dl in the detemir/aspart and NPH/regular insulin groups, respectively (P = 0.80). A BG target below 140 mg/dl before meals was achieved in 45% of patients in the detemir/aspart group and 48% in the NPH/regular group (P = 0.86). During treatment, 22 patients (32.8%) in the detemir/aspart group and 16 patients (25.4%) in the NPH/regular group had at least one episode of hypoglycemia (BG <60 mg/dl) during the hospital stay (P = 0.34). Conclusions: Treatment with basal/bolus regimen with detemir once daily and aspart before meals results in equivalent glycemic control and no differences in the frequency of hypoglycemia compared to a split-mixed regimen of NPH and regular insulin in patients with type 2 diabetes. Copyright © 2009 by The Endocrine Society.
Authors & Co-Authors
Umpierrez, Guillermo E.
United States, Atlanta
Emory University
United States, Atlanta
Emory University School of Medicine
Umpierrez, Denise
United States, Atlanta
Emory University
Baldwin, David S.
United States, Chicago
Rush University Medical Center
Statistics
Citations: 132
Authors: 3
Affiliations: 3
Identifiers
Doi:
10.1210/jc.2008-1441
ISSN:
0021972X
Research Areas
Health System And Policy
Noncommunicable Diseases