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Comparison of the Efficacy and Safety of Insulin Detemir and Insulin Glargine in Hospitalized Patients with Type 2 Diabetes: A Randomized Crossover Trial

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Abstract

Introduction

Previous studies comparing insulin detemir versus insulin glargine showed conflicting results, and included only outpatients. This study compared the two insulin analogs once daily in hospitalized patients with type 2 diabetes (T2D).

Methods

A total of 55 patients aged 18–80 years with hyperglycemia admitted to the endocrinology wards were screened between June 2014 and February 2015. Forty-two enrolled patients were randomly assigned to receive either insulin detemir followed by insulin glargine once daily (n = 21), or vice versa (n = 21). The two insulin analogs were titrated 0.1 U/kg once daily based on fasting blood glucose (FBG). After achieving FBG <7.8 mmol/L (the first period), subjects were switched from one analog to the other (the second period) with no change in the dose. The second period lasted for 3 days. When hypoglycemia occurred in the second period, the observation was discontinued. Six-point blood glucose including FBG, 2 h after breakfast, lunch, dinner, bedtime, and at 3:00 am was tested every day. The glucose profiles of the final days in the two periods were compared.

Results

At the end of the first period, days for achieving FBG target (4.0 ± 0.5 days vs. 3.3 ± 0.4 days, t = 1.079, P = 0.286) and total daily dose (30.1 ± 2.4 U vs. 30.1 ± 2.9 U, t = 0.002, P = 0.999) between insulin detemir and insulin glargine were similar. There was no significant difference in the 24-h glucose control between the two analogs. No hypoglycemia occurred with both analogs in the first period. However, in the second period, when insulin glargine was switched to insulin detemir, two, three and, one patients had hypoglycemia events on day 1, day 2 and day 3 of the second period, respectively. One patient had severe hypoglycemia on day 1.

Conclusion

When both basal insulin analogs were given once daily in T2D, insulin detemir achieved similar efficacy to insulin glargine. On the other hand, there may be differences in action of the compared basal insulins. Further studies with larger patient samples are necessary to support evidence and reveal possible mechanisms.

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Acknowledgments

This study was funded by the Science and Information Technology of Guangzhou (Grant 12C22021649). The article processing charges for this publication were supported by the authors. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published.

Disclosures

Tong Zhang, Mingrun Lin, Wangen Li, Xiuyun Fan, Tao Du, Yunjuan Zhao, and Xiaodan Zhang have nothing to disclose.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China

    Tong Zhang

  2. Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Mingrun Lin, Wangen Li, Xiuyun Fan, Tao Du, Yunjuan Zhao & Xiaodan Zhang

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  1. Tong Zhang
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  2. Mingrun Lin
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Corresponding author

Correspondence to Wangen Li.

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Compliance with Ethics Guidelines.

The study regimen was approved by the ethical board of each participating hospital. All patients provided written informed consent before participating in the study.

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Zhang, T., Lin, M., Li, W. et al. Comparison of the Efficacy and Safety of Insulin Detemir and Insulin Glargine in Hospitalized Patients with Type 2 Diabetes: A Randomized Crossover Trial. Adv Ther 33, 178–185 (2016). https://doi.org/10.1007/s12325-016-0288-7

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  • DOI: https://doi.org/10.1007/s12325-016-0288-7

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