Lower risk of hypoglycaemia and greater odds for weight loss with initiation of insulin detemir compared with insulin glargine in Turkish patients with type 2 diabetes mellitus: local results of a multinational observational study

BMC Endocrine Disorders

Jiten Vora²  Tanzer Balkir¹  Anne Louise Svendsen⁵  Rifat Emral³  Taner Damci⁴ 

[1] Department of Clinical, Medical, & Regulatory Affairs, Novo Nordisk Saglik Urunleri Tic. Ltd. Sti., Etiler-Istanbul, Turkey;Department of Diabetes and Endocrinology, Royal Liverpool University Hospital, Liverpool, UK;Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Ankara University, Ibn-i Sina Hospital, Ankara, Turkey;Department of Endocrinology, Diabetes and Metabolism, Cerrahpasa Medical School, Istanbul University, 34363 Istanbul, Turkey;Department of Biostatistics & Epidemiology, Novo Nordisk A/S, Søborg, Denmark

关键词: Hypoglycaemia;    Weight loss;    Type 2 diabetes;    Basal insulin;    Insulin glargine;    Insulin detemir;   

Others  :  1085170
DOI  :  10.1186/1472-6823-14-61

 received in 2013-07-11, accepted in 2014-07-15,  发布年份 2014

【 摘 要 】

Background

The purpose of this analysis is to evaluate the safety and effectiveness of insulin initiation with once-daily insulin detemir (IDet) or insulin glargine (IGlar) in real-life clinical practice in Turkish patients with type 2 diabetes mellitus (T2DM).

Methods

This was a 24-week multinational observational study of insulin initiation in patients with T2DM.

Results

The Turkish cohort (n = 2886) included 2395 patients treated with IDet and 491 with IGlar. The change in glycosylated haemoglobin (HbA_1c) from the pre-insulin levels was -2.21% [95% confidence interval (CI) -2.32, -2.09] in the IDet group and -1.88% [95% CI -2.17, -1.59] in the IGlar group at the final visit. The incidence rate of minor hypoglycaemia increased in both groups from the pre-insulin to the final visit (+0.66 and +2.23 events per patient year in the IDet and IGlar groups, respectively). Weight change in the IDet group was -0.23 kg [95% CI -0.49, 0.02 kg], and +1.55 kg [95% CI 1.11, 2.00 kg] in the IGlar group. Regression analysis with adjustment for previously identified confounders (age, gender, duration of diabetes, body mass index, previous history of hypoglycaemia, microvascular disease, number and change in oral anti-diabetic drug therapy, HbA_1c at baseline and insulin dose) identified an independent effect of insulin type (IDet versus IGlar) with a risk of at least one episode of hypoglycaemia (odds ratio (OR): 0.33 [95% CI 0.21, 0.52], p <0.0001), and weight loss ≥1 kg (OR: 1.75 [95% CI 1.18, 2.59], p = 0.005), but not on HbA_1c (+0.05% [95% CI -0.15, 0.25%], p = 0.6).

Conclusions

Initiation of basal insulin analogues, IDet and IGlar, were associated with clinically significant glycaemic improvements. A lower risk of minor hypoglycaemia and greater odds of weight loss ≥1 kg was observed with IDet compared with IGlar.

Trial registration

NCT00825643 and NCT00740519

【 授权许可】

   
2014 Damci et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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