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DOI: 10.1055/s-0029-1243230
© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Comparison of Insulin Detemir and Insulin Glargine on Glycemic Variability in Patients with Type 1 and Type 2 Diabetes
Publication History
received 07.08.2009
first decision 14.10.2009
accepted 18.11.2009
Publication Date:
12 January 2010 (online)
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Abstract
Aims: To compare the glycemic variability of insulin detemir and insulin glargine in type 1 and type 2 diabetic patients.
Methods: 15 type 1 and 14 type 2 diabetic patients receiving intensive insulin therapy with insulin glargine were enrolled. Before and after switching insulin glargine to insulin detemir, we assessed fasting glucose variability using the standard deviation (SD) and the coefficient of variance (CV) of self-monitored fasting blood sugar (FBS) levels.
Results: The SD and CV values were significantly decreased in type 1 diabetes after switching the therapy, though there was no significant difference in type 2 diabetes. The frequency of hypoglycemia was decreased in type 1 diabetes and there was no change in type 2 diabetes. The changes of the CV value also showed significant positive correlation with fasting serum CPR levels in all patients and total insulin dose in type 1 diabetes. The changes of frequency of hypoglycemia showed significant positive correlation with total and basal insulin dose adjusted for body weight in type 1 diabetes.
Conclusion: The present study demonstrated lower within-subject variability of insulin detemir compared to insulin glargine, suggesting that the basal insulin replacement with insulin detemir may provide a useful therapeutic strategy for uncontrolled type 1 diabetes with high glucose variability.
Key words
insulin detemir - insulin glargine - hypoglycemia - glycemic variability - diabetes mellitus
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Correspondence
A. ToneMD, PhD
Department of Diabetes and Metabolism
National Hospital Organization
Okayama Medical Center
1711-1, Tamasu, Kita-ku
701-1192 Okayama
Japan
Phone: +81-86-294-9911
Fax: +81-86-294-9255
Email: aitone@okayama3.hosp.go.jp