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Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain in patients with type 2 diabetes who were insulin naive or treated with NPH or insulin glargine: clinical practice experience from a German subgroup of the PREDICTIVE study *
Author(s) -
Meneghini L. F.,
Rosenberg K. H.,
Koenen C.,
Merilainen M. J.,
Lüddeke H.J.
Publication year - 2007
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2006.00674.x
Subject(s) - insulin detemir , nph insulin , medicine , insulin , insulin glargine , type 2 diabetes , diabetes mellitus , regimen , endocrinology , basal (medicine) , hypoglycemia
Aim: The Predictable Results and Experience in Diabetes through Intensification and Control to Target: An International Variability Evaluation (PREDICTIVE) Study is a large, multi‐centre, observational study assessing the safety and efficacy of insulin detemir in everyday clinical practice. Methods: This subgroup analysis of the German cohort of PREDICTIVE evaluates over 3 months, patients with type 2 diabetes who were transferred to insulin detemir ± oral antidiabetic drugs (OADs) from an OAD‐only regimen (n = 1321), NPH insulin ± OADs (n = 251) or insulin glargine ± OADs (n = 260). Results: Among all groups, 3 months after starting treatment with insulin detemir, total, daytime and nocturnal hypoglycaemic events/patient were reduced by 84, 80 and 90%, respectively, from baseline. No major hypoglycaemic events were reported during treatment with insulin detemir. HbAlc was significantly reduced from baseline in each of the subgroups (−1.29,−0.60 and−0.59% for patients previously taking OADs only, NPH insulin ± OADs and insulin glargine ± OADs respectively; p < 0.0001), as was fasting blood glucose (FBG) (−58.1,−29.1 and−24.6 mg/dl; p < 0.0001) and FBG variability−8.2 mg/dl,−5.7 mg/dl; p < 0.0001 and −5.1 mg/dl; p = 0.0008). All subgroups combined lost an average of 0.9 kg of body weight (p < 0.0001) during the study. Total daily basal insulin dose increased slightly from baseline for those patients on a prior insulin regimen, and in this study 79% of patients used insulin detemir once daily. Conclusions: These data confirm the short‐term safety and efficacy of insulin detemir ± OADs in a real‐world scenario and support the findings of randomized controlled clinical trials with insulin detemir, including its limited effects on body weight.